Prospective non interventional Study Evaluating Prognostic and Predictive value of PDL-1 expression and associated T-cell infiltration in Primary Laryngeal Squamous Cell Carcinoma
Abstract Background Immune system plays an important role in cancer evolution. However, cancer cells affect the immune system and use it for its growth and survival. Tumor infiltration lymphocytes and PDL-1 expression proved to play an important prognostic role in different malignancies. We aimed at...
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Published in | QJM : An International Journal of Medicine Vol. 114; no. Supplement_1 |
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Main Authors | , , , , |
Format | Journal Article |
Language | English |
Published |
Oxford University Press
01.10.2021
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Online Access | Get full text |
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Summary: | Abstract
Background
Immune system plays an important role in cancer evolution. However, cancer cells affect the immune system and use it for its growth and survival. Tumor infiltration lymphocytes and PDL-1 expression proved to play an important prognostic role in different malignancies. We aimed at evaluating this role in laryngeal cancer.
Methodology
We prospectively analyzed the pre-treatment paraffin blocks for laryngeal cancer patients, whether on the laryngoscopy or operative specimens, to identify the CD8-positive cells in the tumor epithelium or stroma and the PDL-1 expression on the tumor cells. Appropriate tissue was used as positive control; placenta for PDL-1 and tonsil for CD8. A total score formed of the sum of percentage and intensity of PDL-1. A final comprehensive rate was considered as low expression when combined percentage and intensity score from 0 to 4, and high expression when score from 5-7. According to the distribution, the CD8+T cell invasion was divided into strong infiltration (> 10/100 of epithelial cells; >20/100 stromal cell infiltration) and weak infiltration (< 10/100 epithelial cells; < 20/100 stromal cell infiltration).
Results
40 patients were included in our study; 12 patients had early stage disease (I or II) and 28 with advanced stage (III or IV). PDL-1 expression was positive in 92.5%. Neither the PDL-1 nor CD-8 were found significantly correlated to OS in the whole population, however patients with advanced stage, median OS was significantly low for negative or low compared to high PDL-1 expression (11.7 vs 25.2 months (p = 0.036)), a trend of better OS in high CD8 Epithelial expression (25.1 versus 15.9, P = 0.514) and again trend of higher OS in high CD8 Stromal expression (25.3 versus 15.6 months, p = 0.375). Also there were significant correlation between the CD8 expression in the tumor epithelium and stroma with the PDL-1 expression with p-value of 0.001 and < 0.0001 respectively.
Conclusion
there is a positive correlation between tumor infiltration lymphocytes and PDL-1 expression in laryngeal squamous carcinoma and the higher PDL-1 expression in advanced stage laryngeal cancer is associated with better OS. |
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ISSN: | 1460-2725 1460-2393 |
DOI: | 10.1093/qjmed/hcab103.011 |