The Forth Hospital of Hebei Medical University, No.12, Jiankang Road, 050011, Shijiazhuang City, Hebei, China.
The Forth Hospital of Hebei Medical University, No.12, Jiankang Road, 050011, Shijiazhuang City, Hebei, China.
Pathol Res Pract. 2020 Mar;216(3):152802. doi: 10.1016/j.prp.2019.152802. Epub 2019 Dec 24.
OBJECTIVE: Triple-negative breast cancer (TNBC), a complex and highly aggressive subtype of breast cancer, generally has the poorest clinical outcome, there is a pressing need for more effective therapeutic strategies. Immune checkpoint inhibitors against programmed death 1/programmed death ligand 1 (PD1/PDL1) have revolutionized treatment of several solid tumours, such as non-small cell lung carcinoma (NSCLC), renal, malignant melanoma. However, no checkpoint inhibitors were previously approved for the treatment of TNBC. So far, very limited data have reported PDL1 (SP142) expression and its relationship with clinicopathological behaviors and survival in TNBC. METHODS: PD-L1(SP142) immunohistochemistry was performed on 223 TNBC cases and assessed in tumour cells(TC) as well as tumor-infiltrating lymphocytes(TILs).The relationships between PD-L1 expression and clinicopathological characteristic both in TC and TILs. Futhermore,we also explored the effect of PD-L1 expression on prognosis as illustrated by overall survival(OS). RESULTS: PD-L1 expression was detected in both tumor cells and TILs at a ratio of 8.5 % and 25.1 % respectively. PD-L1 expression in TILs was related to histological grade and abundance of TILs. Tumor cell expression of PD-L1 was not associated with outcome. While PD-L1 expression in TILs and lymphnode transfer were associated with a poor outcome, and PD-L1 expression was an independently prognostic of overall survival (OS) (HR = 0.867, P = 0.029). CONCLUSION: PD-L1 expression in TILs, but not in tumor cells, was a poor prognostic factor in TNBC. These data provide further impetus for assessing immunotherapy in TNBC, in view of the clinical significance of the expression of PD-L1 (SP142) in TNBC.
目的:三阴性乳腺癌(TNBC)是一种复杂且高度侵袭性的乳腺癌亚型,通常具有最差的临床结局,因此迫切需要更有效的治疗策略。针对程序性死亡受体 1/程序性死亡配体 1(PD1/PDL1)的免疫检查点抑制剂已经彻底改变了包括非小细胞肺癌(NSCLC)、肾细胞癌、恶性黑色素瘤在内的多种实体瘤的治疗。然而,之前没有检查点抑制剂被批准用于治疗 TNBC。到目前为止,只有非常有限的数据报道了 PD-L1(SP142)的表达及其与 TNBC 的临床病理行为和生存的关系。
方法:对 223 例 TNBC 病例进行 PD-L1(SP142)免疫组化检测,并在肿瘤细胞(TC)和肿瘤浸润淋巴细胞(TIL)中进行评估。TC 和 TIL 中 PD-L1 表达与临床病理特征的关系。此外,我们还通过总生存(OS)来探讨 PD-L1 表达对预后的影响。
结果:PD-L1 表达在肿瘤细胞和 TIL 中分别以 8.5%和 25.1%的比例被检测到。TIL 中的 PD-L1 表达与组织学分级和 TIL 的丰度有关。肿瘤细胞中 PD-L1 的表达与结局无关。而 TIL 中的 PD-L1 表达和淋巴结转移与不良预后相关,PD-L1 表达是总生存(OS)的独立预后因素(HR=0.867,P=0.029)。
结论:TIL 中的 PD-L1 表达,而不是肿瘤细胞中的 PD-L1 表达,是 TNBC 的不良预后因素。鉴于 PD-L1(SP142)在 TNBC 中的表达具有临床意义,这些数据为评估 TNBC 的免疫治疗提供了进一步的动力。
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