Takamori Shinkichi, Takada Kazuki, Tagawa Tetsuzo, Toyokawa Gouji, Hirai Fumihiko, Yamashita Nami, Okamoto Tatsuro, Oki Eiji, Yoshizumi Tomoharu, Oda Yoshinao, Maehara Yoshihiko
Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka-shi, Fukuoka 812-8582, Japan.
Department of Thoracic Oncology, National Kyushu Cancer Center, 3-1-1 Notame, Minami-ku, Fukuoka 811-1395, Japan.
Surg Oncol. 2018 Dec;27(4):637-641. doi: 10.1016/j.suronc.2018.08.001. Epub 2018 Aug 11.
It has been reported that the tumor microenvironment, including tumor-associated immune cells (ICs) and programmed cell death-ligand 1 (PD-L1) expression, differs between primary and metastatic tumors. This study aimed to elucidate the differences in PD-L1 expression on tumor cells (TCs) and ICs between lung metastases and corresponding primary tumors.
We analyzed paired lesions from 44 patients diagnosed with lung metastases between 2005 and 2017 at Kyushu University. The percentages of PD-L1-positive TCs and ICs in lung metastases and the primary tumor were classified into five categories (0: <1%; 1: 1%-4%; 2: 5%-9%; 3: 10%-49%; and 4: ≥50%). Lesions in which ≥1% of the TCs and ICs were PD-L1-positive were considered positive.
The primary cancers included rectal (n = 19), colon (n = 10), liver (n = 10), bile duct (n = 2), stomach (n = 1), gall bladder (n = 1) and breast (n = 1). Discrepancies in PD-L1 expression on TCs and ICs between lung metastases and primary lesions were observed in 5 (11.4%, κ = 0.23) and 9 (20.5%, κ = 0.11) of the 44 cases, respectively. PD-L1 expression on ICs was higher in lung metastases than paired primary tumors (p = 0.026), although the percentage of PD-L1-positive TCs was not significantly different between lung metastases and primary tumors (p = 0.767).
There were significant differences in PD-L1 expression on TCs and ICs between lung metastases and primary tumors. Clinicians should be aware of these differences in the tumor microenvironment when treating patients with immunotherapy.
据报道，肿瘤微环境，包括肿瘤相关免疫细胞（ICs）和程序性细胞死亡配体1（PD-L1）表达，在原发性肿瘤和转移性肿瘤之间存在差异。本研究旨在阐明肺转移瘤与相应原发性肿瘤之间肿瘤细胞（TCs）和ICs上PD-L1表达的差异。
我们分析了2005年至2017年在九州大学诊断为肺转移瘤的44例患者的配对病变。肺转移瘤和原发性肿瘤中PD-L1阳性TCs和ICs的百分比分为五类（0：<1%；1：1%-4%；2：5%-9%；3：10%-49%；4：≥50%）。TCs和ICs中≥1%为PD-L1阳性的病变被视为阳性。
原发性癌症包括直肠癌（n = 19）、结肠癌（n = 10）、肝癌（n = 10）、胆管癌（n = 2）、胃癌（n = 1）、胆囊癌（n = 1）和乳腺癌（n = 1）。44例病例中，分别有5例（11.4%，κ = 0.23）和9例（20.5%，κ = 0.11）观察到肺转移瘤与原发性病变之间TCs和ICs上PD-L1表达的差异。肺转移瘤中ICs上的PD-L1表达高于配对的原发性肿瘤（p = 0.026），尽管肺转移瘤与原发性肿瘤之间PD-L1阳性TCs的百分比无显著差异（p = 0.767）。
肺转移瘤与原发性肿瘤之间TCs和ICs上的PD-L1表达存在显著差异。临床医生在对患者进行免疫治疗时应注意肿瘤微环境中的这些差异。
