Wang Chuying, Yu Jiao, Fan Yangwei, Ma Ke, Ning Jing, Hu Yuan, Niu Wenxia, Dong Xuyuan, Wu Yinying, Li Enxiao, Dong Danfeng
Department of Medical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an.
Department of Radiotherapy, Shaanxi Provincial People' Hospital, Xi'an, Shaanxi, China.
Ann Clin Lab Sci. 2019 Sep;49(4):448-456.
This study examined the tumor expression of programmed cell death ligand 1 (PD-L1)/programmed cell death protein 1 (PD-1) in patients with GEP-NEN. This study aims to reveal the relationship of their expression with clinicopathological characteristics and prognosis.
PD1 and PD-L1 expression in tumors from 120 GEP-MEN patients was evaluated using immunohistochemistry. The correlations of the expression of PDL1/PD1 and clinicopathological features were assessed.
Immunohistochemical staining indicated that PD-L1 was expressed in the tumor cells of 52.5% patients with GEP-NENs, and PD-L1 expression was positively correlated with the World Health Organization (WHO) classification, American Joint Committee on Cancer (AJCC) stage, lymphatic metastasis and prognosis. Meanwhile, PD-1 was expressed in tumor infiltrating lymphocytes within 55.8% tumor samples, and PD-1 expression was positively correlated with AJCC stage and GEP-NENs prognosis. Moreover, survival analysis indicated that the overall median survival of patients with PD-L1/PD-1-positive tumors significantly differed from that of patients with PD-L1/PD-1-negative tumors. Multivariate analysis confirmed that AJCC stage and Chromogranin A expression in tumor tissues were independent prognostic factors for overall survival. In conclusion, PDL1 was an independent prognostic factor for patients with GEP-NENs. Our results suggested that patients with GEP-NENs might be appropriate for PD1/PDL1-targeted therapy.
Our findings show that the expression of PD-L1 and PD-1 correlates with patient prognosis, and may thus serve as potential pathological prognostic markers of GEP-NENs. Immunotherapy using PD-1/PD-L1 inhibitors may be a promising strategy for GEP-NENs patients with PD-L1/PD-1 positively expressed.
本研究检测了胃肠胰神经内分泌肿瘤（GEP-NEN）患者肿瘤中程序性细胞死亡配体1（PD-L1）/程序性细胞死亡蛋白1（PD-1）的表达情况。本研究旨在揭示其表达与临床病理特征及预后的关系。
采用免疫组织化学法评估120例GEP-NEN患者肿瘤组织中PD-1和PD-L1的表达情况。评估PD-L1/PD-1表达与临床病理特征的相关性。
免疫组织化学染色显示，52.5%的GEP-NEN患者肿瘤细胞中表达PD-L1，且PD-L1表达与世界卫生组织（WHO）分类、美国癌症联合委员会（AJCC）分期、淋巴结转移及预后呈正相关。同时，55.8%的肿瘤样本中肿瘤浸润淋巴细胞表达PD-1，且PD-1表达与AJCC分期及GEP-NEN预后呈正相关。此外，生存分析表明，PD-L1/PD-1阳性肿瘤患者的总中位生存期与PD-L1/PD-1阴性肿瘤患者有显著差异。多因素分析证实，AJCC分期及肿瘤组织中嗜铬粒蛋白A表达是总生存的独立预后因素。总之，PD-L1是GEP-NEN患者的独立预后因素。我们的结果提示，GEP-NEN患者可能适合接受PD-1/PD-L1靶向治疗。
我们的研究结果表明，PD-L1和PD-1的表达与患者预后相关，因此可能作为GEP-NEN潜在的病理预后标志物。对于PD-L1/PD-1阳性表达的GEP-NEN患者，使用PD-1/PD-L1抑制剂进行免疫治疗可能是一种有前景的策略。
