Department of Pathology, Aarhus University Hospital, Aarhus, Denmark.
Division of Medical Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea.
Cancer Med. 2021 Dec;10(23):8365-8376. doi: 10.1002/cam4.4333. Epub 2021 Oct 24.
The ability of the T-cell-inflamed gene expression profile (GEP) to predict clinical outcome in esophageal cancer (EC) is unknown. This retrospective observational study assessed the prognostic value of GEP and programmed death ligand 1 (PD-L1) expression in patients with EC treated in routine clinical practice.
Tumor samples of 294 patients from three centers in Denmark, South Korea, and the United States, collected between 2005 and 2017, were included. T-cell-inflamed GEP score was defined as non-low or low using a cutoff of -1.54. A combined positive score (CPS) ≥10 was defined as PD-L1 expression positivity. Associations between overall survival (OS) and GEP status and PD-L1 expression were explored by Cox proportional hazards models adjusting for age, sex, histology, stage, and performance status.
Median age was 65 years; 63% of patients had adenocarcinoma (AC) and 37% had squamous cell carcinoma (SCC). Thirty-six percent of tumors were GEP non-low, with higher prevalence in AC (46%) than SCC (18%). Twenty-one percent were PD-L1-positive: 32% in South Korean samples versus 16% in non-Asian samples and 26% in SCC versus 18% in AC. GEP scores and PD-L1 CPS were weakly correlated (Spearman's R = 0.363). OS was not significantly associated with GEP status (non-low vs low; adjusted hazard ratio, 0.91 [95% CI, 0.69-1.19]) or PD-L1 expression status.
Neither GEP nor PD-L1 expression was a prognostic marker in Asian and non-Asian patients with EC.
T 细胞炎症基因表达谱（GEP）预测食管癌（EC）临床结局的能力尚不清楚。本回顾性观察性研究评估了 GEP 和程序性死亡配体 1（PD-L1）表达在常规临床实践中治疗的 EC 患者中的预后价值。
纳入了来自丹麦、韩国和美国的三个中心的 294 名患者的肿瘤样本，采集时间为 2005 年至 2017 年。使用-1.54 的截值将 T 细胞炎症 GEP 评分定义为非低或低。将联合阳性评分（CPS）≥10 定义为 PD-L1 表达阳性。通过 Cox 比例风险模型调整年龄、性别、组织学、分期和表现状态，探讨总生存期（OS）与 GEP 状态和 PD-L1 表达之间的关系。
中位年龄为 65 岁；63%的患者为腺癌（AC），37%为鳞状细胞癌（SCC）。36%的肿瘤为 GEP 非低，AC（46%）高于 SCC（18%）。21%为 PD-L1 阳性：韩国样本为 32%，非亚洲样本为 16%，SCC 为 26%，AC 为 18%。GEP 评分和 PD-L1 CPS 相关性较弱（Spearman's R=0.363）。OS 与 GEP 状态（非低与低；调整后的危险比，0.91[95%CI，0.69-1.19]）或 PD-L1 表达状态均无显著相关性。
在亚洲和非亚洲 EC 患者中，GEP 和 PD-L1 表达均不是预后标志物。
