Liu Zhenhua, Meng Yisen, Cao Yudong, Chen Yuke, Fan Yu, Li Shaobo, He Qun, Wu Shiliang, Yu Wei, Jin Jie
Department of Urology, Peking University First Hospital and Institute of Urology, National Research Center for Genitourinary Oncology, Beijing 100034, China.
Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Urology, Peking University Cancer Hospital & Institute, Beijing 100142, China.
Transl Androl Urol. 2020 Apr;9(2):428-436. doi: 10.21037/tau.2020.02.12.
Non-schistosoma-associated urinary bladder squamous cell carcinoma (SqCC) has low incidence and is associated with chronic inflammation. Due to its unique etiology and pathology, expression of programmed cell death ligand 1 (PD-L1) in SqCC could be different from that of urothelial carcinoma, which may contribute to different responses to immunotherapy. In this study, we intended to explore the expression profile and prognostic value of PD-L1 in non-schistosoma-associated urinary bladder SqCC under the consideration of tumor-infiltrating lymphocytes' (TILs) density.
We conducted a retrospective study to review 604 bladder cancer patients who received radical cystectomy (RC) from 2009 to 2013 in Peking University First Hospital. We enrolled 67 bladder SqCC patients in total, including pure SqCC (n=19) and mixed SqCC (n=48, with urothelial carcinoma). PD-L1 protein expression and TILs density were evaluated by immunohistochemistry.
Nine female and 58 male patients (median age 67.4 years) were enrolled in the present study. There were 15 stage T1-2 patients and 52 stage T3-4 patients. 27 patients had N1-2 lymph node metastasis. Overall, 61.2% cases were PD-L1-positive. Dense TILs coincided with higher PD-L1 expression rate. Median survival time of PD-L1 positive cases was significantly higher than negative cases (P=0.026). During multivariate analysis, positive PD-L1 expression and dense TILs were independent protective factors affecting overall survival (OS, PD-L1: P=0.022; TILs: P=0.010) and progression free survival (PFS, PD-L1: P=0.018; TILs: P=0.009).
PD-L1 expression and dense TILs were frequently detected in urinary bladder SqCC tumors. Positive PD-L1 expression and dense TILs were correlated with better survival outcomes in non-schistosoma-associated urinary bladder SqCC. The immunotherapy targeting PD-L1 might be helpful to bladder SqCC patients.
非血吸虫相关性膀胱鳞状细胞癌（SqCC）发病率较低，与慢性炎症相关。由于其独特的病因和病理，SqCC中程序性细胞死亡配体1（PD-L1）的表达可能与尿路上皮癌不同，这可能导致对免疫治疗的反应不同。在本研究中，我们旨在探讨在考虑肿瘤浸润淋巴细胞（TILs）密度的情况下，非血吸虫相关性膀胱SqCC中PD-L1的表达谱及预后价值。
我们进行了一项回顾性研究，以回顾2009年至2013年在北京大学第一医院接受根治性膀胱切除术（RC）的604例膀胱癌患者。我们共纳入67例膀胱SqCC患者，包括纯SqCC（n=19）和混合SqCC（n=48，合并尿路上皮癌）。通过免疫组织化学评估PD-L1蛋白表达和TILs密度。
本研究纳入9例女性和58例男性患者（中位年龄67.4岁）。有15例T1-2期患者和52例T3-4期患者。27例患者有N1-2淋巴结转移。总体而言，61.2%的病例PD-L1呈阳性。密集的TILs与较高的PD-L1表达率一致。PD-L1阳性病例的中位生存时间显著高于阴性病例（P=0.026）。在多变量分析中，PD-L1阳性表达和密集的TILs是影响总生存期（OS，PD-L1：P=0.022；TILs：P=0.010）和无进展生存期（PFS，PD-L1：P=0.018；TILs：P=0.009）的独立保护因素。
在膀胱SqCC肿瘤中经常检测到PD-L1表达和密集的TILs。在非血吸虫相关性膀胱SqCC中，PD-L1阳性表达和密集的TILs与更好的生存结果相关。针对PD-L1的免疫治疗可能对膀胱SqCC患者有益。
