Expression of PD-1 and PD-L1 in poorly differentiated neuroendocrine carcinomas of the digestive system: a potential target for anti-PD-1/PD-L1 therapy.

Expression of PD-1 and PD-L1 in poorly differentiated neuroendocrine carcinomas of the digestive system: a potential target for anti-PD-1/PD-L1 therapy.
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DOI:
10.1016/j.humpath.2017.10.003
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发表时间:
2017-12
期刊:
影响因子:
3.3
通讯作者:
Shi C
Shi C
中科院分区:
医学3区
文献类型:
--
作者:
Roberts JA;Gonzalez RS;Das S;Berlin J;Shi C

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消化系统低分化神经内分泌癌的预后很差,治疗选择有限。本研究旨在探讨PD-1/PD-L1通路在这些肿瘤中的表达。对37例消化系统低分化神经内分泌癌患者进行了研究。对他们的电子病历、病理报告和病理切片进行了人口统计学、临床病史和病理特征的审查。采用免疫组织化学方法标记肿瘤组织中PD-1和PD-L1的表达,分析比较小细胞和大细胞神经内分泌癌中PD-1和PD-L1在肿瘤和肿瘤相关免疫细胞上的表达。患者平均年龄61岁,男18例,女19例。结直肠(n=20)是最常见的原发部位,其他原发部位包括胰胆管系统、食道、胃、十二指肠和壶腹。PD-1表达于肿瘤细胞(n=6,16%)和肿瘤相关免疫细胞(n=23,63%)。6例肿瘤细胞表达PD-1,免疫细胞也表达PD-1。PD-L1表达于肿瘤细胞5例(14%),肿瘤相关免疫细胞10例(27%)。PD-1和PD-L1在小细胞和大细胞神经内分泌癌中的表达差异无统计学意义。结论:PD-1/PD-L1在消化系统低分化神经内分泌癌中的表达是常见的。针对PD-1/PD-L1通路的检查点阻断可能在治疗这种疾病方面有潜在的作用。
Poorly-differentiated neuroendocrine carcinoma of the digestive system has a dismal prognosis with limited treatment options. This study aimed to investigate expression of the PD-1/PD-L1 pathway in these tumors. Thirty-seven patients with a poorly-differentiated neuroendocrine carcinoma of the digestive system were identified. Their electronic medical records, pathology reports and pathology slides were reviewed for demographics, clinical history and pathologic features. Tumor sections were immunohistochemically labeled for PD-1 and PD-L1 and expression of PD-1 and PD-L1 on tumor and tumor-associated immune cells was analyzed and compared between small cell and large cell neuroendocrine carcinomas. The mean age of patients was 61 years old with 18 males and 19 females. The colorectum (n=20) was the most common primary site, other primary sites included the pancreaticobiliary system, esophagus, stomach, duodenum, and ampulla. Expression of PD-1 was detected on tumor cells (n=6, 16%) as well as on tumor-associated immune cells (n=23, 63%). The 6 cases with PD-1 expression on tumor cells also had the expression on immune cells. Expression of PD-L1 was visualized on tumor cells in 5 cases (14%), and on tumor-associated immune cells in 10 cases (27%). There was no difference in PD-1 and PD-L1 expression between small cell and large cell neuroendocrine carcinomas. In conclusion, PD-1/PD-L1 expression is a frequent occurrence in poorly-differentiated neuroendocrine carcinomas of the digestive system. Checkpoint blockade targeting the PD-1/PD-L1 pathway may have a potential role in treating patients with this disease.
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