程序性细胞死亡配体1（PD-L1）和主要组织相容性复合体I类（MHC I类）在三阴性乳腺癌中的表达模式及其病理相关性
Programmed Cell Death Ligand 1 (PD-L1) and Major Histocompatibility Complex Class I (MHC Class I) Expression Patterns and Their Pathologic Associations in Triple-Negative Breast Cancer.
作者信息
Kaewkedsri Ponkrit, Intarawichian Piyapharom, Jessadapattarakul Sirawich, Kunprom Waritta, Koonmee Supinda, Thanee Malinee, Somintara Ongart, Wongbuddha Anongporn, Chadbunchachai Payia, Nawapun Supajit, Aphivatanasiri Chaiwat
机构信息
Department of Pathology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
出版信息
Breast Cancer (Dove Med Press). 2025 Feb 6;17:123-143. doi: 10.2147/BCTT.S506833. eCollection 2025.
PURPOSE
This study aims to investigate the clinicopathological characteristics of triple-negative breast cancer (TNBC) in relation to programmed cell death ligand 1 (PD-L1) and major histocompatibility complex class I (MHC class I) expression, with a focus on their prognostic significance.
PATIENTS AND METHODS
A retrospective analysis was conducted on formalin-fixed paraffin-embedded (FFPE) tissue samples from 148 TNBC patients diagnosed between 2008 and 2021. Immunohistochemical analysis evaluated PD-L1 and MHC class I expression. PD-L1 was assessed using Combine Positive Scores (CPS), with the threshold set at CPS ≥ 1 and CPS ≥ 10. MHC class I expression was categorized into low and high levels. Associations between these markers, clinicopathological features, overall survival (OS), and disease-free survival (DFS) were analyzed. PD-L1 expression was also compared between older FFPE blocks (2008-2018) versus newer blocks (2019-2021).
RESULTS
PD-L1 expression was observed in 29.1% of cases with a Combined Positive Score (CPS) ≥1 and 8.8% of CPS ≥10 cases. MHC class I expression was evenly split between low and high levels. Older FFPE blocks (2008-2018) showed lower PD-L1 expression than newer blocks (2019-2021). There was no significant association between PD-L1 expression and overall survival (OS) or disease-free survival (DFS). However, high MHC class I expression was strongly associated with improved OS (HR = 0.469, 95% CI: 0.282-0.780, p=0.004). Patients with negative PD-L1 and high MHC class I expression had the most favorable prognosis, with significant OS for CPS ≥1 (HR = 0.447, 95% CI: 0.236-0.846, p=0.013) and CPS ≥10 (HR = 0.516, 95% CI: 0.307-0.869, p=0.013).
CONCLUSION
These findings support the potential of PD-L1 and MHC class I expression as prognostic markers for TNBC, offering insights to guide treatment decisions and improve patient outcomes.
目的
本研究旨在探讨三阴性乳腺癌（TNBC）与程序性细胞死亡配体1（PD-L1）和主要组织相容性复合体I类（MHC I类）表达相关的临床病理特征，重点关注其预后意义。
患者与方法
对2008年至2021年间确诊的148例TNBC患者的福尔马林固定石蜡包埋（FFPE）组织样本进行回顾性分析。免疫组织化学分析评估PD-L1和MHC I类表达。使用联合阳性评分（CPS）评估PD-L1，阈值设定为CPS≥1和CPS≥10。MHC I类表达分为低水平和高水平。分析这些标志物、临床病理特征、总生存期（OS）和无病生存期（DFS）之间的关联。还比较了旧的FFPE样本块（2008 - 2018年）与新的样本块（2019 - 2021年）之间的PD-L1表达。
结果
29.1%的病例观察到PD-L1表达，联合阳性评分（CPS）≥1，8.8%的病例CPS≥10。MHC I类表达在低水平和高水平之间均匀分布。旧的FFPE样本块（2008 - 2018年）显示的PD-L1表达低于新的样本块（2019 - 2021年）。PD-L1表达与总生存期（OS）或无病生存期（DFS）之间无显著关联。然而，高MHC I类表达与改善的OS密切相关（HR = 0.469，95%CI：0.282 - 0.780，p = 0.004）。PD-L1阴性且MHC I类表达高的患者预后最有利，CPS≥1时OS显著（HR = 0.447，95%CI：0.236 - 0.846，p = 0.013），CPS≥10时OS显著（HR = 0.516，95%CI：0.307 - 0.869，p = 0.013）。
结论
这些发现支持了PD-L1和MHC I类表达作为TNBC预后标志物的潜力，为指导治疗决策和改善患者预后提供了见解。
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