PD-L1 表达对可切除结肠癌生存的临床影响。

Clinical Impact of PD-L1 Expression for Survival in Curatively Resected Colon Cancer.

机构信息

Department of Pathology, Gil Medical Center, College of Medicine, Gachon University, Incheon, Korea.

Department of Surgery, Gil Medical Center, College of Medicine, Gachon University, Incheon, Korea.

出版信息

Cancer Invest. 2020 Aug;38(7):406-414. doi: 10.1080/07357907.2020.1793349. Epub 2020 Aug 7.

DOI:10.1080/07357907.2020.1793349

PMID:32762373

Abstract

BACKGROUND

Programmed death 1 (PD-1) and its ligand PD-L1 play a key dysfunction of T lymphocytes. The purpose of this study was to assess and compare the prognostic role of tumor- TILs and its relationship with PD-L1 expression in stage II and III colon cancer.

METHODS

Immunohistochemisty was used to assess the densities of CD8, CD4, and FOXP3 cells, and PD-L1 expression in intraepithelial tumor site from 58 stage II and III colon cancers. These were evaluated for association with histopathologic features and overall survival.

RESULTS

PD-L1-positive tumors contained a higher number of CD8 TILs with statistical significance ( = 0.001). CD4 TILs showed positive correlation with PD-L1 expression ( = 0.034). There were no associations between PD-L1 expression and FOXP3 TILs. Microsatellite instability (MSI)-high status ( = 0.001; Odd ration 18.0; 95% CI = 4.3-74.8) was the strongest prognostic factor along with mucinous/poor cell differentiation, CD8 and right tumor location was associated with PD-L1 expression ( = 0.024, 0.035 and 0.033, respectively).

CONCLUSION

This study demonstrated that PD-L1 expression was associated with MSI-high, increased CD8 TILs, mucinous and poor cell differentiation, and right-sided tumor location.

摘要

背景

程序性死亡受体 1（PD-1）及其配体 PD-L1 对 T 淋巴细胞的功能具有关键的抑制作用。本研究旨在评估和比较 II 期和 III 期结肠癌中肿瘤浸润 T 淋巴细胞（TILs）及其与 PD-L1 表达的预后作用及其关系。

方法

采用免疫组织化学法检测 58 例 II 期和 III 期结肠癌肿瘤上皮内肿瘤部位 CD8、CD4 和 FOXP3 细胞的密度及 PD-L1 表达情况，并评估其与组织病理学特征和总生存的关系。

结果

PD-L1 阳性肿瘤中 CD8 TILs 的数量更高，具有统计学意义（ = 0.001）。CD4 TILs 与 PD-L1 表达呈正相关（ = 0.034）。PD-L1 表达与 FOXP3 TILs 之间无相关性。微卫星不稳定（MSI）高状态（ = 0.001；比值比 18.0；95%置信区间 4.3-74.8）是最强的预后因素，此外，黏液/低分化、CD8 和右肿瘤位置与 PD-L1 表达相关（ = 0.024、0.035 和 0.033）。