Expression of PD-L1 Attenuates the Positive Impacts of High-level Tumor-infiltrating Lymphocytes on Prognosis of Triple-negative Breast Cancer
Expression of PD-L1 Attenuates the Positive Impacts of High-level Tumor-infiltrating Lymphocytes on Prognosis of Triple-negative Breast Cancer
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DOI：
10.1080/15384047.2019.1595282
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发表时间：
2019-03
影响因子：
3.6
通讯作者：
Xudong Zhu;Qingzhao Zhang;Dan Wang;Caigang Liu;B. Han;Jin-Ming Yang
中科院分区：
文献类型：
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作者：
Xudong Zhu;Qingzhao Zhang;Dan Wang;Caigang Liu;B. Han;Jin-Ming Yang
摘要背景：在所有乳腺癌亚型中，三阴性乳腺癌（TNBC）具有侵袭性临床表现，包括更频繁的复发和转移。PD-L1表达和肿瘤浸润淋巴细胞（TIL）在TNBC临床病理行为和患者生存结局中的作用尚不清楚。方法：采用免疫组织化学方法检测108例随访5年以上的TNBC患者PD-L1和TIL的表达。分析PD-L1表达与肿瘤浸润性淋巴细胞（TILs）及临床病理特征的关系。此外，我们探讨了PD-L1表达和TIL对无病生存期（DFS）预后的影响。结果如下：PD-L1的表达与TNBC患者中更具侵袭性的临床病理行为相关，包括较大的肿瘤大小、较高的PL-1-ALN发生率、较频繁的远处转移和较低的无病生存率。相比之下，与低水平TIL患者相比，高水平TIL患者显示出较低的侵袭性疾病进展，因此预后更好。在高水平TIL患者中，PD-L1表达与不良预后相关。结论：TNBC患者中PD-L1和低水平TIL的表达与不良临床结局相关。然而，PD-L1表达减弱了高水平TIL的积极影响。我们的研究结果表明，在TNBC患者中选择适用于抗PD-L1/抗PD 1免疫治疗的病例的潜在生物标志物。
ABSTRACT Background: Among all breast cancer subtypes, triple-negative breast cancer (TNBC) has aggressive clinical manifestations including more frequent relapses and metastases. The roles of PD-L1 expression and tumor-infiltrating lymphocytes (TILs) in TNBC clinicopathological behaviors and patients’ survival outcomes remain unclear. Methods: TNBC (108 cases) patients with at least 5-year follow-up were analyzed for PD-L1 expression and TILs by immunohistochemistry. We also analyzed the relationships between PD-L1 expression, TILs and clinicopathological characteristics. Furthermore, we explored the effect of PD-L1 expression and TILs on prognosis as illustrated by disease-free survival (DFS). Results: The expression of PD-L1 was related to more aggressive clinicopathological behaviors in TNBC patients including a larger tumor size, higher incidence of PL-1-ALN, more frequent distant metastasis, and a reduced disease-free survival. In contrast, patients with high-level TILs showed less aggressive disease progression hence a better prognosis compared to patients with low-level TILs. Among patients with high-level TILs, PD-L1 expression was correlated with adverse prognosis. Conclusions: Expression of PD-L1 and low-level TILs in TNBC patients were associated with adverse clinical outcomes. However, the positive impact of high-level TILs was attenuated by PD-L1 expression. Our results suggest potential biomarkers for a selection of indicated cases in the TNBC patients for anti-PD-L1/anti-PD1 immunotherapy.