PUCRS School of Medicine, Porto Alegre, Brazil.
PUCRS School of Medicine, Porto Alegre, Brazil; Department of Urology, Hospital Sao Lucas da PUCRS, Porto Alegre, Brazil.
Clin Genitourin Cancer. 2020 Jun;18(3):e254-e259. doi: 10.1016/j.clgc.2019.10.014. Epub 2019 Oct 16.
Penile squamous cell carcinoma (PSCC) is a rare malignancy with higher incidence in developing countries. Treatment options include surgery, radiation therapy, and systemic chemotherapy. However, effective treatments for advanced disease are lacking. To understand the biology underlying PSCC may help the development of new therapeutic strategies. The objective of this study was to evaluate immunohistochemical expression of programmed death-ligand 1 (PD-L1) and p16 in PSCC and its association with clinicopathologic features and outcomes.
A cohort of 40 patients with PSCC from an academic institution in Brazil was analyzed. Clinicopathologic features and outcomes were retrospectively collected. PD-L1 and p16 immunohistochemical expression were performed in formalin-fixed paraffin-embedded specimens. PD-L1 was positive with any staining in more than 1% of tumor, and p16 was positive in more than 10%. Associations were performed using the Mann-Whitney and Fisher exact test. Kaplan-Meier curves were used to estimate survival rates with log-rank.
Of 35 patients, 5 were excluded, 4 owing to a lack of data and 1 owing to no tumor available; 18 (51.4%) patients were PD-L1-positive (PD-L1). PD-L1 was associated with larger tumors (P = .027). There was an association between PD-L1 and p16 expression (P = .002). PD-L1 was more frequent in grade II and III disease than grade I (77.8% vs. 22.2%) and was expressed in all patients with grade III disease. Lymph node involvement was associated with PD-L1 expression (69.2% PD-L1 vs. 30.8% PD-L1-negative). The 5-year mortality was 37.1%.
PD-L1 expression appears to be associated with p16 expression, larger tumors, and worse clinical outcomes in PSCC and may provide clinical data for new studies to evaluate anti-PD-L1 immune therapies.
阴茎鳞状细胞癌（PSCC）是一种罕见的恶性肿瘤，在发展中国家发病率较高。治疗选择包括手术、放射治疗和全身化疗。然而，对于晚期疾病缺乏有效的治疗方法。了解 PSCC 的生物学基础可能有助于新治疗策略的发展。本研究的目的是评估程序性死亡配体 1（PD-L1）和 p16 在 PSCC 中的免疫组织化学表达及其与临床病理特征和结局的关系。
对巴西一家学术机构的 40 例 PSCC 患者进行了队列分析。回顾性收集临床病理特征和结局。在福尔马林固定石蜡包埋标本中进行 PD-L1 和 p16 的免疫组织化学表达。PD-L1 阳性为肿瘤中任何染色超过 1%，p16 阳性为超过 10%。采用 Mann-Whitney 和 Fisher 确切检验进行相关性分析。Kaplan-Meier 曲线用于对数秩检验估计生存率。
35 例患者中，有 5 例被排除，4 例因缺乏数据，1 例因无肿瘤；18 例（51.4%）患者 PD-L1 阳性（PD-L1）。PD-L1 与较大的肿瘤相关（P=0.027）。PD-L1 与 p16 表达之间存在关联（P=0.002）。PD-L1 在 II 级和 III 级疾病中比 I 级更常见（77.8%比 22.2%），且在所有 III 级疾病患者中均有表达。淋巴结受累与 PD-L1 表达相关（69.2%PD-L1 阳性比 30.8%PD-L1 阴性）。5 年死亡率为 37.1%。
PD-L1 表达似乎与 p16 表达、较大的肿瘤和 PSCC 更差的临床结局相关，并可能为新的抗 PD-L1 免疫治疗研究提供临床数据。
