PD-L1 expression is associated with massive lymphocyte infiltration and histology in gastric cancer

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• 作者：Zhongwu Li ; MD ; PhD^a ; ¹ ; Yumei Lai ; MD ; PhD^a ; ¹ ; Li Sun ; MD^a ; Xiaotian Zhang ; MD^b ; Ruping Liu ; PhD^c ; Guoshuang Feng ; PhD^d ; Lixin Zhou ; MD^a ; Lin Jia ; MD^a ; Xiaozheng Huang ; MD^a ; Qiang Kang ; MD^a ; Dongmei Lin ; MD ; PhD^a ; Jing Gao ; PhD^b ; ^{gaojing100142@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Lin Shen ; MD^b ; ^{lin100@medmail.com.cn" class="auth_mail" title="E-mail the corresponding author}
• 关键词：PD-L1 ; EBV ; Gastric cancer ; Prognosis ; HER2
• 刊名：Human Pathology
• 出版年：2016
• 出版时间：September 2016
• 年：2016
• 卷：55
• 期：Complete
• 页码：182-189
• 全文大小：2166 K

文摘

The mechanism of carcinogenesis of gastric cancer (GC) is still unclear now. This study aimed to explore the correlations among PD-L1, Epstein-Barr virus (EBV) infection, lymphocyte infiltration, HER2 expression, HER2 gene status, histology, and other clinicopathological factors in GC. A total of 44 GC patients with massive lymphocyte infiltration (GC-MLI) and 93 GC patients without massive lymphocyte infiltration were involved in this study. Immunohistochemical analysis was used to test the expression levels of PD-L1 and HER2. Fluorescence in situ hybridization was used on HER2-positive cases with a score of 2 + to test the HER2 gene status. EBV-encoded RNA was used to test for EBV infection. In univariate analysis, PD-L1 expression was significantly associated with GC-MLI (P < .001), lower age (P = .019), EBV infection (P < .001), lower HER2 expression (P = .011), and diffuse/mixed type of histology (P = .022). EBV-encoded RNA–positive cases were significantly associated with GC-MLI (P < .001), lower age (P = .016), diffuse/mixed type of histology (P = .011), and lower HER2 expression (P = .032). In the multivariate logistic regression model, GC-MLI and the diffuse/mixed type histology were identified as 2 independent factors that affected PD-L1 expression (P < .001). Furthermore, PD-L1–positive cases have worse overall survival than do PD-L1–negative cases (P = .011). These results suggest that massive lymphocyte infiltration and the diffuse/mixed type histology of GC should be taken into consideration to select the appropriate patients for PD-L1 inhibitory treatment in the future.