Department of Urology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, 123, Ta-Pei Road, Niaosung, Kaohsiung, 83301, Taiwan.
Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, 100 Shih-Chuan 1st Road, Kaohsiung, 80708, Taiwan.
Cancer Immunol Immunother. 2021 Oct;70(10):2981-2990. doi: 10.1007/s00262-021-02890-y. Epub 2021 Mar 19.
Upper tract urothelial carcinoma (UTUC) is relatively rare in Western countries. The impact of programmed death-ligand 1 (PD-L1) expression on UTUC remains unclear because previous studies have focused on bladder UC. We investigated the association of PD-L1 expression with clinicopathological features and prognosis in patients with UTUC.
We retrospectively reviewed the patients with UTUC that we treated at our institute from 2013 to 2018. In total, 105 patients with UTUC undergoing radical nephroureterectomy were analyzed to evaluate the PD-L1 expression on representative whole-tissue sections using the Combined Positive Score (CPS; Dako 22C3 pharmDx assay). A PD-L1 CPS ≥ 10 was considered positive.
Among the 105 UTUC cases, 17.1% exhibited positive PD-L1 expression. A CPS ≥ 10 was significantly associated with higher tumor stage (≥ T2, p = 0.034) and lymph node invasion at diagnosis (p = 0.021). A multivariable analysis indicated that a CPS ≥ 10 was an independent prognostic predictor of shorter cancer-specific survival (hazard ratio [HR] = 4.59, 95% confidence interval [CI] = 1.66 - 12.7, p = 0.003) and overall survival (HR = 2.51, 95% CI = 1.19 - 5.27, p = 0.015).
A PD-L1 CPS ≥ 10 in UTUC was associated with adverse pathological features and independently predicted worse cancer-specific and overall survival.
上尿路尿路上皮癌（UTUC）在西方国家相对少见。程序性死亡配体 1（PD-L1）表达对 UTUC 的影响尚不清楚，因为先前的研究集中在膀胱癌上。我们研究了 PD-L1 表达与 UTUC 患者临床病理特征和预后的关系。
我们回顾性分析了 2013 年至 2018 年在我院治疗的 UTUC 患者。对 105 例行根治性肾输尿管切除术的 UTUC 患者进行分析，使用联合阳性评分（CPS；Dako 22C3 pharmDx 检测）评估代表全组织切片的 PD-L1 表达。PD-L1 CPS≥10 被认为是阳性。
在 105 例 UTUC 病例中，17.1%表现出阳性 PD-L1 表达。CPS≥10 与更高的肿瘤分期（≥T2，p=0.034）和诊断时的淋巴结侵犯显著相关（p=0.021）。多变量分析表明，CPS≥10 是癌症特异性生存（危险比 [HR] = 4.59，95%置信区间 [CI] = 1.66-12.7，p=0.003）和总生存（HR = 2.51，95%CI = 1.19-5.27，p=0.015）的独立预后预测因子。
UTUC 中 PD-L1 CPS≥10 与不良病理特征相关，并独立预测癌症特异性和总生存更差。
