Surgical Pathology Unit, Department of Medicine (DIMED), University of Padua, via Gabelli 61, 35121, Padua, PD, Italy.
Unit of Medical Oncology 1, Department of Oncology, Istituto Oncologico Veneto, IOV-IRCCS, Padua, PD, Italy.
Virchows Arch. 2020 Jul;477(1):151-156. doi: 10.1007/s00428-019-02693-8. Epub 2019 Nov 14.
Immunotherapy has been recently approved for gastric (GC) and gastroesophageal-junction adenocarcinomas (GEC), and PD-L1 immunohistochemical evaluation represents a promising predictive biomarker in this oncological setting. A series of 125 gastroesophageal dysplastic lesions (52 low-grade, 73 high-grade) was investigated for PD-L1 and DNA mismatch repair proteins status. PD-L1 was positive (combined positive score (CPS) ≥ 1) in 48 (31.0%) dysplastic lesions. A higher prevalence of PD-L1-positive cases was observed among esophageal specimens compared with gastric ones (p = 0.0003), in high-grade and adenocarcinoma samples in comparison with low-grade dysplasia (p < 0.0001), and in lesions with mismatch repair deficiency (p = 0.028). For 30 dysplastic samples, a synchronous matched invasive lesion (GC = 15, GEC = 15) was available and tested for PD-L1 expression; a discordant PD-L1 status was observed in 12/30 (40%) cases. A relatively high prevalence in PD-L1 positivity was observed among gastroesophageal dysplastic lesions and this should be taken into consideration for future therapeutic strategies based on this biomarker.
免疫疗法最近已被批准用于治疗胃癌（GC）和胃食管交界处腺癌（GEC），PD-L1 免疫组化评估在这种肿瘤治疗环境中是一种很有前途的预测生物标志物。我们研究了一系列 125 例胃食管发育不良病变（52 例低级别，73 例高级别），以评估 PD-L1 和 DNA 错配修复蛋白的状态。在 48 例（31.0%）发育不良病变中 PD-L1 呈阳性（综合阳性评分（CPS）≥1）。与胃标本相比，食管标本中 PD-L1 阳性病例的发生率更高（p=0.0003），与低级别病变相比，高级别和腺癌样本中 PD-L1 阳性病例的发生率更高（p<0.0001），与错配修复缺陷的病变相比，PD-L1 阳性病例的发生率更高（p=0.028）。对于 30 例发育不良的样本，有同步的匹配侵袭性病变（GC=15，GEC=15）可用于检测 PD-L1 表达；在 12/30（40%）例中观察到 PD-L1 状态不一致。胃食管发育不良病变中 PD-L1 阳性率较高，这在未来基于该生物标志物的治疗策略中应予以考虑。
