Department of Otorhinolaryngology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
Department of Pathology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
Curr Oncol. 2023 Jan 20;30(2):1450-1460. doi: 10.3390/curroncol30020111.
Human papillomavirus (HPV) infection detected in oropharyngeal squamous cell carcinoma (OPSCC) is associated with a better survival outcome from previous literature. However, Thailand and several Asian countries have a low prevalence of HPV-associated OPSCC and, therefore, have a low positive rate of immunostaining with p16. Tumor microenvironments (TME), including tumor-infiltrating CD8+ lymphocytes (CD8+ TIL) and programmed death ligand 1 (PD-L1), are proposed as significant prognostic indicators in addition to p16.
Explore the expression p16, CD8+ TIL, and PD-L1 and its value as prognostic indicators for overall survival (OS) in patients with OPSCC.
Data from patients with OPSCC diagnosed from 2012 to 2018 were recovered from medical records and national registry. All available glass slides and slides of immunohistochemistry (IHC) of p16, CD8, and PD-L1 were reviewed. The TME was classified into four types according to the expression pattern of PD-L1 and CD8+TIL. Overall survival (OS) was assessed using the Kaplan-Meier method and Cox regression model analysis.
In 160 OPSCC patients, p16 was positive in 27 (16.88%). The density of CD8+ TIL was higher in the p16+ and PD-L1+ groups ( = 0.005, 0.039); however, there was no association between p16 and the status of PD-L1. P16 and CD8+ TIL were significant prognostic factors for better OS ( = 0.007, 0.001), but not PD-L1 status ( = 0.317). Among the four types of TME, carcinoma showed mainly type IV TME (PD-L1-/TIL+), while OPSCCs with type I TME (PD-L1+/TIL+) had the best survival outcome.
The positivity of p16 and the density of CD8+ TIL were associated with better OS in OPSCC, while the status of PD-L1 was not significantly related to OS. OPSCC with type I TME (PD-L1+/TIL+) showed the best prognosis of all types of TME.
探讨人乳头瘤病毒（HPV）感染与口腔鳞状细胞癌（OPSCC）患者总生存（OS）的相关性。
从病历和国家登记处获取 2012 年至 2018 年 OPSCC 患者的数据。回顾所有可用的玻璃切片和 HPV16、CD8 和 PD-L1 的免疫组化（IHC）切片。根据 PD-L1 和 CD8+TIL 的表达模式，将 TME 分为四型。采用 Kaplan-Meier 法和 Cox 回归模型分析评估总生存（OS）。
在 160 例 OPSCC 患者中，p16 阳性率为 16.88%（27/160）。p16+和 PD-L1+组 CD8+TIL 密度较高（=0.005，0.039）；然而，p16 与 PD-L1 状态之间无相关性。p16 和 CD8+TIL 是 OS 更好的显著预后因素（=0.007，0.001），但 PD-L1 状态不是（=0.317）。四种 TME 类型中，癌主要表现为 IV 型 TME（PD-L1-/TIL+），而具有 I 型 TME（PD-L1+/TIL+）的 OPSCC 患者具有最佳的生存结局。
p16 阳性和 CD8+TIL 密度与 OPSCC 的 OS 相关，而 PD-L1 状态与 OS 无显著相关性。所有 TME 类型中，I 型 TME（PD-L1+/TIL+）的 OPSCC 患者预后最佳。
