Clinical interest of PD-L1 immuno-histochemistry expression as a predictive factor of Bacillus Calmette Guerin (BCG) efficacy in refractory high-risk non-muscle-invasive bladder cancer (NMIBC)
Clinical interest of PD-L1 immuno-histochemistry expression as a predictive factor of Bacillus Calmette Guerin (BCG) efficacy in refractory high-risk non-muscle-invasive bladder cancer (NMIBC)
复制标题
DOI：
10.1007/s00345-019-02896-3
复制
发表时间：
2020-06-01
影响因子：
3.4
通讯作者：
Pfister, Christian
中科院分区：
文献类型：
--
作者：
Delcourt, Clara;Gemival, Pierre;Pfister, Christian
目的 评估肿瘤 (TC) 和肿瘤浸润免疫细胞 (IC) 中 PD-L1 的表达作为高危 NMIBC 中卡介苗治疗失败的预测因素。材料和方法 纳入接受完全切除、随后膀胱 BCG 灌注治疗的高危 NMIBC 患者。早期复发（ER）定义为BCG诱导过程后肿瘤复发。使用精确的 Fisher 测试变体研究了 ER 与肿瘤细胞 (TC) 和肿瘤浸润免疫细胞 (IC) 的免疫组织化学 PD-L1（E1L3N 克隆）表达之间的关联。结果共纳入186例患者，其中ER 38例（20.4%），TC PD-L1表达阳性35例（18.8%），IC PD-L1表达阳性60例（32.3%）。 TC PD-L1 >= 1% 组 (n = 7, 20.0%) 的 ER 频率并不比 TC PD-L1 阴性组 (n = 31, 20.5%) 显着更高 (p = 0.97)。 IC PD-L1阴性的患者中有15例（19.2%）出现ER，IC PD-L1≥1%的患者有23例（21.3%）出现ER。 IC 的 PD-L1 阳性表达（阈值 > 1%）与免疫浸润密度相关（95.2% 密集免疫浸润 vs 47.2% 低免疫浸润，p < 0.05），BCG 治疗后 IC 的 PD-L1 表达增加（p = 0.006）。结论 BCG 治疗后免疫组化 PD-L1 阳性与 ER 之间没有关联。尽管如此，免疫浸润和 PD-L1 阳性之间的关系证实了评估免疫浸润密度以定义肿瘤概况的兴趣。
Objective To assess PD-L1 expression in tumor (TC) and tumor infiltrating immune cells (IC) as a predictive factor of BCG therapy failure in high-risk NMIBC. Materials and methods Patients treated with complete resection followed by bladder BCG instillation for high-risk NMIBC were included. Early recurrence (ER) was defined as tumor recurrence after BCG induction course. The association between ER and immuno-histochemistry PD-L1 (E1L3N clone) expression by tumors cells (TC) and tumor infiltrating immune cells (IC) was investigated using an exact Fisher test variant. Results A total of 186 patients were included, of whom 38 (20.4%) were ER, 35 (18.8%) were positive for TC PD-L1 expression and 60 (32.3%) were positive for IC PD-L1. ER was not significantly (p = 0.97) more frequent in the TC PD-L1 >= 1% group (n = 7, 20.0%) than in the TC PD-L1-negative group (n = 31, 20.5%). Patients with IC PD-L1 negative had ER in 15 (19.2%) cases and patients with IC PD-L1 >= 1% had ER in 23 (21.3%) cases. PD-L1-positive expression for IC (threshold > 1%) was correlated with immune infiltrate density (95.2% dense immune infiltrate vs 47.2% low immune infiltrate, p < 0.05), with increased expression of PD-L1 by IC after BCG therapy (p = 0.006). Conclusion No association was observed between immuno-histochemistry PD-L1 positivity and ER after BCG therapy. Nevertheless, the relationship between immune infiltrate and PD-L1 positivity confirmed the interest of assessing the immune infiltrate density to define tumor's profile.