Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Okayama, 700-8558, Japan.
Department of Pathology and Experimental Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan.
J Gastroenterol. 2019 Nov;54(11):1019-1028. doi: 10.1007/s00535-019-01586-6. Epub 2019 Apr 29.
Recently, therapeutic antibodies against programmed death-1/programmed death-ligand 1 (PD-1/PD-L1) have shown promising clinical results for several solid tumors, including pancreatic cancer. In this study, we evaluated the relationship between the PD-L1 expression of surgical resected and fine-needle aspiration (FNA) specimens for patients with pancreatic cancer.
Of 121 patients who underwent endoscopic ultrasound-guided (EUS)-FNA before surgery for pancreatic cancer in an academic center, the 94 (78%) with adequate FNA specimens for a histological evaluation were retrospectively analyzed. All the patients had undergone upfront surgery without any chemotherapy or radiotherapy. We performed immunohistochemistry (IHC) staining to investigate the PD-L1 expression in both resected and FNA specimens. The positive-stained cells were counted, and their percentage was used for the investigation.
Of the 94 patients, 16 (17%) and 11 (10%) were defined as positive on resected cancer specimens using cutoff points of 5% and 10% positively stained cancer cell counts, respectively. The concordance rates for the positive frequency of PD-L1 expression between resected and FNA specimens were 44% (7/16) and 55% (6/11) when the positivity was set to ≥ 5% and ≥ 10%, respectively. The concordance rates for the negative frequency of PD-L1 expression between two specimens were 97% (76/78) and 99% (82/83) when the positivity was set to ≥ 5% and ≥ 10%, respectively.
Approximately, half of the patients with PD-L1 expression positive and almost all the patients with PD-L1 expression negative could be diagnosed on FNA specimens.
最近，针对程序性死亡受体 1/程序性死亡配体 1（PD-1/PD-L1）的治疗性抗体在包括胰腺癌在内的几种实体瘤中显示出了有前景的临床结果。在这项研究中，我们评估了手术切除标本和细针穿刺（FNA）标本中 PD-L1 表达与胰腺癌患者之间的关系。
在一家学术中心，对 121 例因胰腺癌接受内镜超声引导（EUS）-FNA 检查的患者进行了回顾性分析，其中 94 例（78%）有足够的 FNA 标本进行组织学评估。所有患者均接受了初始手术，没有接受任何化疗或放疗。我们进行了免疫组织化学（IHC）染色，以研究切除和 FNA 标本中的 PD-L1 表达。对阳性染色细胞进行计数，并计算其百分比。
在 94 例患者中，16 例（17%）和 11 例（10%）分别在切除的肿瘤标本中使用 5%和 10%阳性染色肿瘤细胞计数的截断值定义为阳性。当阳性设定为≥5%和≥10%时，PD-L1 表达阳性频率在切除和 FNA 标本之间的一致性率分别为 44%（7/16）和 55%（6/11）。当阳性设定为≥5%和≥10%时，PD-L1 表达阴性频率在两个标本之间的一致性率分别为 97%（76/78）和 99%（82/83）。
大约一半 PD-L1 表达阳性的患者和几乎所有 PD-L1 表达阴性的患者都可以通过 FNA 标本诊断。
