Siraj Abdul K, Parvathareddy Sandeep Kumar, Annaiyappanaidu Padmanaban, Haqawi Wael, Al-Rasheed Maha, AlManea Hadeel M, AlHussaini Hussah F, Al-Dayel Fouad, Al-Kuraya Khawla S
Human Cancer Genomic Research, Research Center, King Faisal Specialist Hospital and Research Center, P.O. Box 3354, Riyadh 11211, Saudi Arabia.
Department of Pathology, King Faisal Specialist Hospital and Research Centre, P.O. Box 3354, Riyadh 11211, Saudi Arabia.
J Pers Med. 2021 Jan 26;11(2):73. doi: 10.3390/jpm11020073.
Several clinical trials are investigating the use of immune-targeted therapy with Programmed death ligand-1 (PD-L1) inhibitors for colorectal cancer (CRC), with promising results for patients with mismatch repair (MMR) deficiency or metastatic CRC. However, the prognostic significance of PD-L1 expression in CRC is controversial and such data are lacking in CRC from Middle Eastern ethnicity. We carried out this large retrospective study to investigate the prognostic and clinico-pathological impact of PD-L1 expression in Middle Eastern CRC using immunohistochemistry. A total of 1148 CRC were analyzed for PD-L1 expression. High PD-L1 expression was noted in 37.3% (428/1148) cases and was correlated with aggressive clinico-pathological features such as high malignancy grade ( < 0.0001), larger tumor size ( = 0.0007) and mucinous histology ( = 0.0005). Interestingly, PD-L1 expression was significantly higher in patients exhibiting MMR deficiency ( = 0.0169) and mutation ( = 0.0008). Furthermore, the expression of PD-L1 was found to be an independent marker for overall survival (HR = 1.45; 95% CI = 1.06 - 1.99; = 0.0200). In conclusion, the results of this study indicate that PD-L1 expression could be a valid biomarker for poor prognosis in Middle Eastern CRC patients. This information can help in decision-making for anti-PD-L1 therapy in Middle Eastern CRC, especially for patients with MMR deficient tumors.
多项临床试验正在研究使用程序性死亡配体-1（PD-L1）抑制剂进行免疫靶向治疗在结直肠癌（CRC）中的应用，对于错配修复（MMR）缺陷或转移性CRC患者取得了有前景的结果。然而，PD-L1表达在CRC中的预后意义存在争议，并且中东种族CRC患者缺乏此类数据。我们开展了这项大型回顾性研究，以通过免疫组织化学研究PD-L1表达在中东CRC中的预后及临床病理影响。共分析了1148例CRC的PD-L1表达情况。37.3%（428/1148）的病例存在高PD-L1表达，且与侵袭性临床病理特征相关，如高恶性分级（<0.0001）、更大肿瘤大小（=0.0007）和黏液组织学（=0.0005）。有趣的是，在表现出MMR缺陷（=0.0169）和 突变（=0.0008）的患者中，PD-L1表达显著更高。此外，发现PD-L1表达是总生存的独立标志物（HR = 1.45；95%CI = 1.06 - 1.99；=0.0200）。总之，本研究结果表明，PD-L1表达可能是中东CRC患者预后不良的有效生物标志物。该信息有助于中东CRC患者抗PD-L1治疗的决策制定，尤其是对于MMR缺陷肿瘤患者。
