Programmed death-ligand 1 expression in the tumour stroma of colorectal liver oligometastases and its association with prognosis after liver resection  

程序性细胞死亡配体1在结直肠癌肝脏寡转移灶的表达及其预后价值

作　　者：Jian-Hong Peng Yi Tai Yi-Xin Zhao Bao-Jia Luo Qing-Jian Ou Zhi-Zhong Pan Lin Zhang Zhen-Hai Lu 

机构地区：[1]Department of Colorectal Surgery,Sun Yat-sen University Cancer Center,State Key Laboratory of Oncology in South China,Collaborative Innovation Center for Cancer Medicine Guangzhou,Guangdong,P.R.China [2]Department of Clinical Laboratory,Sun Yat-sen University Cancer Center,State Key Laboratory of Oncology in South China,Collaborative Innovation Center for Cancer Medicine,Guangzhou,Guangdong,P.R.China

出　　处：《Gastroenterology Report》2021年第5期443-450,I0002,共9页胃肠病学报道（英文）

基　　金：The present study was funded by grants from the National Natural Science Foundation of China[No.81772595];the Sun Yat-sen University Clinical Research 5010 Program[No.2015024 and 2013013]。

摘　　要：Background The clinical value of programmed death-ligand 1(PD-L1)expression in colorectal liver oligometastases(CLOs)remains undefined.This study aimed to detect PD-L1 in the microenvironment of CLOs and determine its association with patient prognosis.Methods We collected 126 liver-resection specimens from CLO patients who underwent curative liver resection between June 1999 and December 2016.Immunohistochemistry(IHC)was performed to assess PD-L1 expression in paraffinembedded specimens.Overall survival(OS)and recurrence-free survival(RFS)were analysed using the Kaplan–Meier method and log-rank test.Results PD-L1 was mainly expressed in the stroma of liver oligometastases.Patients with high PD-L1 expression had a higher proportion of clinical-risk scores(CRSs)of 2–4(67.7%vs 40.4%;P=0.004).With a median 58-month follow-up,patients with high PD-L1 expression had a significantly lower 3-year OS rate(65.5%vs 92.7%;P=0.001)and 3-year RFS rate(34.7%vs 83.8%;P<0.001)than patients with low PD-L1 expression.Multivariate Cox analysis demonstrated that high PD-L1 expression(hazard ratio[HR]=3.581;95%confidence interval[CI]2.301–9.972;P=0.015),CRS 2–4(HR=6.960;95%CI 1.135–42.689;P=0.036)and increased preoperative CA19-9(HR=2.843;95%CI 1.229–6.576;P=0.015)were independent risk factors for OS.High PD-L1 expression(HR=4.815;95%CI 2.139–10.837;P<0.001)and lymph-node metastasis(HR=2.115;95%CI 1.041–4.297;P=0.038)were independent risk factors for RFS.Conclusion This study found that PD-L1 was commonly expressed in the tumour stroma of CLOs and high PD-L1 expression was associated with poor prognosis.背景:程序性细胞死亡配体1(PD-L1)在结直肠癌肝脏寡转移灶(CLO)表达的临床价值尚不明确。本研究旨在检测CLO微环境中PDL1的表达,并分析其与患者预后的关系。方法:收集1999年6月至2016年12月之间126例行根治性肝切除术的CLO患者的肝转移瘤标本。免疫组织化学法检测PD-L1在石蜡包埋标本中的表达水平。采用Kaplan-Meier法和Log-rank检验分析总体生存(OS)和无复发生存(RFS)。结果:PD-L1主要在肝转移灶的间质中表达。PD-L1高表达患者的临床风险更高(临床风险评分2–4分者比例:67.7%vs 40.4%,P=0.004)。中位随访58个月,PD-L1高表达患者3年OS(65.5%vs 92.7%,P=0.001)和3年RFS(34.7%vs 83.8%,P<0.001)均显著低于PD-L1低表达者。多因素Cox分析显示,PD-L1高表达(HR=3.581;95%CI 2.301–9.972,P=0.015),CRS 2–4分(HR=6.960,95%CI 1.135–42.689,P=0.036)及术前CA19-9增高(HR=2.843,95%CI 1.229–6.576,P=0.015)是OS的独立危险因素。PD-L1高表达(HR=4.815,95%CI 2.139–10.837,P<0.001)和原发灶淋巴结转移(HR=2.115,95%CI 1.041–4.297,P=0.038)是RFS的独立危险因素。结论:本研究发现PD-L1在CLO患者的肝转移灶间质中普遍表达,其高表达提示预后不良。

关 键 词：PD-L1 colorectal liver oligometastases EXPRESSION PROGNOSIS 

分 类 号：R735[医药卫生—肿瘤]