癌症与免疫反应：PD-1/PD-L1 检查点在喉癌中的作用。初步结果。
Cancer and immune response: The role of PD-1/PD-L1 checkpoint in laryngeal carcinoma. Preliminary results.
机构信息
Unit of Otorhinolaryngology, Department of Biomedicine, Neuroscience and Advanced Diagnostic (BIND), University of Palermo, Palermo, Italy.
Unit of Anesthesia, Intensive Care, and Emergency, Department of Surgical, Oncological and Oral Science (Di.Chir.On.S.), University of Palermo, Palermo, Italy.
出版信息
Eur Arch Otorhinolaryngol. 2024 Oct;281(10):5411-5417. doi: 10.1007/s00405-024-08822-7. Epub 2024 Jul 28.
PURPOSE
The overall survival of laryngeal squamous cell carcinoma (LSCC) hasn't changed significantly in the last decades, leading to a negative prognosis in advanced stages. So, the immunotherapy takes space with the inhibition of PD-1/PD-L1 checkpoint, involved in suppression of immune response.
METHODS
A prospective study was conducted on LSCC patients, selected according to strict criteria. The study was approved by the ethics committee of our Hospital. Parameters were: sex, age, smoking and alcohol habits, C-reactive protein (CRP) level in the serum, laryngeal subsite involved, differentiation-based histopathologic grading of tumor, neck node involvement, tumor stage, expression levels of PD-L1 (as Combined Positive Score - CPS). P-value < 0.05 was statistically significant.
RESULTS
58 patients were included: 31.03% were females, mean age 63.55±10.09. A statistically significant correlation between CPS and smoking habits and N stage was found. CRP resulted increased in 44.83% of patients with a statistically significant correlation with CPS. The most cases were glottic cancers (46.55%). 75.86% of tumors were moderately-differentiated, without correlation with CPS.
CONCLUSION
PD-L1 expression levels are variables independent of sex, age, alcohol consumption, differentiation degree of LSCC. A statistically significant correlation between PD-L1 expression levels and smoking habits, neck node status and CRP was found. This last finding demonstrates the involvement of PD-1/PD-L1 checkpoint in immune response in case of cancer. However, these results need further studies to detect the best patients tailored for treatment with anti-PD-1/PD-L1 blocking antibodies.
目的
喉鳞状细胞癌（LSCC）的总体生存率在过去几十年中没有显著变化，导致晚期预后不佳。因此，免疫疗法占据了 PD-1/PD-L1 检查点抑制的空间，该检查点参与抑制免疫反应。
方法
对 LSCC 患者进行了一项前瞻性研究，根据严格的标准选择患者。该研究得到了我院伦理委员会的批准。参数包括：性别、年龄、吸烟和饮酒习惯、血清 C 反应蛋白（CRP）水平、受累的喉部亚部位、肿瘤的组织病理学分级、颈部淋巴结受累、肿瘤分期、PD-L1 的表达水平（以联合阳性评分-CPS）。P 值<0.05 具有统计学意义。
结果
共纳入 58 例患者：女性占 31.03%，平均年龄 63.55±10.09。CPS 与吸烟习惯和 N 分期之间存在统计学显著相关性。44.83%的患者 CRP 升高，与 CPS 存在统计学显著相关性。最常见的癌症是声门癌（46.55%）。75.86%的肿瘤为中度分化，与 CPS 无相关性。
结论
PD-L1 表达水平是独立于性别、年龄、饮酒、LSCC 分化程度的变量。PD-L1 表达水平与吸烟习惯、颈部淋巴结状态和 CRP 之间存在统计学显著相关性。这一最后发现表明，在癌症的情况下，PD-1/PD-L1 检查点参与了免疫反应。然而，这些结果需要进一步的研究来检测针对抗 PD-1/PD-L1 阻断抗体治疗的最佳患者。
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