基质 PD-L1 表达在结直肠癌肝转移中的作用。

Role of stromal PD-L1 expression in colorectal liver metastasis.

机构信息

Department of Surgery, Tokushima University, Tokushima, Japan.

出版信息

BMC Cancer. 2024 Jan 17;24(1):97. doi: 10.1186/s12885-024-11869-8.

DOI:10.1186/s12885-024-11869-8

PMID:38233811

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10795256/

Abstract

BACKGROUND AND AIM

The outcomes of immune checkpoint blockade for colorectal cancer (CRC) treatment are unsatisfactory. Furthermore, the efficacy of immune checkpoint blockade for liver metastasis of various cancer is poor. Here, we investigated the relationship between stromal programmed death-ligand 1 (PD-L1) expression and the prognosis of patients with colorectal cancer liver metastasis (CRLM).

METHODS

The present study enrolled 84 CRLM patients who underwent surgery (R0) for CRC. Immunohistochemistry was performed to analyze stromal PD-L1 expression in CRLM.

RESULTS

Stromal PD-L1 was expressed in 52.3% of CRLM samples, which was associated with fewer not optimally resectable metastases (p = 0.04). Stromal PD-L1 also tended to associate with a lower tumor grade (p = 0.08). Stromal PD-L1-positive patients had longer overall survival (p = 0.003). Multivariate analysis identified stromal PD-L1 expression (p = 0.008) and poorer differentiation (p < 0.001) as independent prognostic indicators. Furthermore, stromal PD-L1 expression was correlated to a high number of tumor-infiltrating lymphocytes (TILs). Stromal PD-L1- and low TIL groups had shorter OS than stromal PD-L1 + and high TIL groups (46.6% vs. 81.8%, p = 0.05) Stromal PD-L1-positive patients had longer disease-free survival (DFS) (p = 0.03) and time to surgical failure (p = 0.001). Interestingly, stromal PD-L1 expression was positively related to the desmoplastic subtype (p = 0.0002) and inversely related to the replacement subtype of the histological growth pattern (p = 0.008).

CONCLUSIONS

Stromal PD-L1 expression may be a significant prognostic marker for CRLM.

摘要

背景与目的

免疫检查点阻断在结直肠癌（CRC）治疗中的疗效并不理想。此外，免疫检查点阻断在各种癌症肝转移中的疗效也较差。在这里，我们研究了结直肠癌肝转移（CRLM）患者基质程序性死亡配体 1（PD-L1）表达与预后的关系。

方法

本研究纳入了 84 例接受结直肠癌手术（R0）治疗的 CRLM 患者。采用免疫组织化学法分析 CRLM 中基质 PD-L1 的表达。

结果

52.3%的 CRLM 样本中表达了基质 PD-L1，与较少的非最佳可切除转移灶相关（p=0.04）。基质 PD-L1 也与较低的肿瘤分级相关（p=0.08）。基质 PD-L1 阳性患者的总生存期更长（p=0.003）。多变量分析确定基质 PD-L1 表达（p=0.008）和较差的分化（p<0.001）是独立的预后指标。此外，基质 PD-L1 表达与肿瘤浸润淋巴细胞（TILs）的数量有关。基质 PD-L1 阳性和低 TIL 组的总生存期（OS）短于基质 PD-L1 阳性和高 TIL 组（46.6% vs. 81.8%，p=0.05）。基质 PD-L1 阳性患者的无病生存期（DFS）更长（p=0.03）和手术失败时间（p=0.001）。有趣的是，基质 PD-L1 表达与促结缔组织增生型（desmoplastic subtype）呈正相关（p=0.0002），与组织学生长模式的替代型（replacement subtype）呈负相关（p=0.008）。