Prognostic Significance of PD-L1+ and CD8+ Immune Cells in HPV+ Oropharyngeal Squamous Cell Carcinoma
Prognostic Significance of PD-L1+ and CD8+ Immune Cells in HPV+ Oropharyngeal Squamous Cell Carcinoma
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PD-L1+和CD 8+免疫细胞在HPV阳性口咽鳞癌中的预后意义
DOI：
10.1158/2326-6066.cir-17-0299
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发表时间：
2018-03-01
影响因子：
10.1
通讯作者：
Rischin, Danny
中科院分区：
文献类型：
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作者：
Solomon, Benjamin;Young, Richard J.;Rischin, Danny
人类乳头瘤病毒阳性的口咽鳞状细胞癌(HPV+OPSCC)是一种与临床结果相关的独特的头颈部癌症亚群，现有的基于肿瘤淋巴结转移的分期方法无法准确地对其进行分类。考虑到免疫参数的显著影响，例如许多癌症中的肿瘤浸润性淋巴细胞(TIL)，我们试图确定免疫表型肿瘤是否可以改善HPV+OPSCCs的分类以预测预后。在190例HPV+OPSCC患者中，我们对CD8(+)TIL以及PD-L1表达的肿瘤细胞(TC)和免疫细胞(IC)的定位进行了量化和测定。评估这些参数对总生存期(OS)的预后意义，并确定它们对现有预后模型的贡献。61.3%的患者CD8(+)TIL丰度高(间质或瘤内IC=30%)，并与OS的改善相关[HR，0.4；95%可信区间(CI)，0.20.9；P=0.017]。虽然PD-L1在TC上的表达不能预测预后，但在38.5%的肿瘤内IC上，PD-L1的高表达与OS的改善显著相关(HR，0.37；95%CI，0.15~0.93；P=0.023)。在HPV+OPSCC中，高表达的IC PD-L1和丰富的CD8(+)TIL都可以识别预后良好的患者亚群，并提供现有分期系统之外的其他预后信息。(C)2018年AACR。
Human papilloma virus-positive oropharyngeal squamous cell carcinoma (HPV+ OPSCC) represents a distinct subgroup of head and neck cancers associated with clinical outcomes that are not accurately categorized by existing tumor-node-metastasis-based staging methods. Given the significant impact of immune parameters, such as tumor-infiltrating lymphocytes (TIL) in many cancers, we sought to determine if immunophenotyping tumors can improve categorization of HPV+ OPSCCs for prognostic purposes. In a cohort of 190 patients with HPV+ OPSCC, we quantified and determined the localization of CD8(+) TILs, as well as PD-L1-expressing tumor cells (TC) and immune cells (IC). The prognostic significance of these parameters on overall survival (OS) was evaluated, and their contribution to existing prognostic models was determined. High CD8(+) TIL abundance (>= 30% on stromal or intratumoral ICs) was seen in 61.3% patients and was associated with improved OS [HR, 0.4; 95% confidence interval (CI), 0.20.9; P = 0.017]. Although the expression of PD-L1 on TC was not prognostic, high expression of PD-L1 on >= 5% of intratumoral ICs was found in 38.5% patients and was significantly associated with improved OS (HR, 0.37; 95% CI, 0.15-0.93; P = 0.023). Both high intratumoral IC PD-L1 expression and abundant CD8(+) TILs in HPV+ OPSCCs identify subgroups of patients with excellent outcomes and provide additional prognostic information beyond existing staging systems. (C) 2018 AACR.