Department of Neuroscience DNS, Otolaryngology Section, University of Padova, Padova, Italy.
Department of Medicine DIMED, University of Padova, Padova, Italy.
Pathol Res Pract. 2020 Sep;216(9):153120. doi: 10.1016/j.prp.2020.153120. Epub 2020 Jul 13.
The prognostic role of programmed death-ligand 1 (PD-L1) expression and the tumor's immune microenvironment has yet to be investigated in the specific setting of adjuvant postoperative radiotherapy (PORT) for laryngeal carcinoma (LSCC). The main aim of this exploratory study was to investigate, also by cluster analysis, whether PD-L1 expression (in terms of combined positive score [CPS]), tumor-infiltrating lymphocytes (TIL), and tertiary lymphoid structures (TLS) correlated prognostically with response to PORT in a cohort of consecutive LSCC patients.
PD-L1, TIL and TLS were assessed in 24 consecutive patients with LSCC who underwent PORT. Cluster analysis was used to classify cases on the strength of these parameters.
A CPS ≥ 1 was associated with a significantly lower recurrence rate (p = 0.033), and longer disease-free survival (DFS) (p = 0.012) than a CPS < 1. Two clusters of prognostic relevance emerged from our analysis. Cluster 1 was characterized by a mean CPS of 23.0 ± 37.9, a mean TIL count of 68.0 ± 16.4, and the presence of TLS in all cases. Cluster 2 featured a mean CPS of 3.1 ± 7.3, a mean TIL count of 23.9 ± 16.5, and no cases with TLS. Cluster 1 showed a trend towards a lower recurrence rate (p = 0.071) and longer DFS (p = 0.054) than cluster 2.
Judging from this preliminary investigation, assessing PD-L1 and immune microenvironment markers seems a promising approach for identifying patients at higher risk of LSCC recurrence after PORT, who might reasonably benefit from adjuvant postoperative chemo-RT, or immunotherapy.
程序性死亡配体 1（PD-L1）表达和肿瘤免疫微环境的预后作用尚未在喉癌（LSCC）辅助术后放疗（PORT）的特定环境中进行研究。本探索性研究的主要目的是通过聚类分析来研究 PD-L1 表达（以联合阳性评分[CPS]表示）、肿瘤浸润淋巴细胞（TIL）和三级淋巴结构（TLS）是否与一组连续的 LSCC 患者的 PORT 反应相关。
对 24 例接受 PORT 的 LSCC 患者进行 PD-L1、TIL 和 TLS 评估。使用聚类分析根据这些参数对病例进行分类。
CPS≥1 与复发率显著降低（p=0.033）和无病生存率（DFS）延长（p=0.012）相关，而 CPS<1。我们的分析产生了两个具有预后意义的聚类。簇 1 的平均 CPS 为 23.0±37.9，平均 TIL 计数为 68.0±16.4，并且所有病例均存在 TLS。簇 2 的特征是平均 CPS 为 3.1±7.3，平均 TIL 计数为 23.9±16.5，并且没有病例存在 TLS。簇 1 的复发率（p=0.071）和 DFS（p=0.054）均有降低趋势，低于簇 2。
从这项初步研究来看，评估 PD-L1 和免疫微环境标志物似乎是识别 PORT 后 LSCC 复发风险较高患者的一种很有前途的方法，这些患者可能合理地受益于辅助术后放化疗或免疫治疗。
