TY - JOUR
T1 - PD-L1 expression patterns in oral cancer as an integrated approach for further prognostic classification
AU - Miranda-Galvis, Marisol
AU - Rumayor Piña, Alicia
AU - Sales de Sá, Raísa
AU - Almeida Leite, Amanda
AU - Agustin Vargas, Pablo
AU - Calsavara, Vinicius Fernando
AU - Lópes Pinto, Clóvis A.
AU - Teng, Yong
AU - Kowalski, Luiz Paulo
N1 - Funding Information:
This work was supported by the São Paulo Research Foundation—FAPESP (M.M.G, grant 2016/03248‐1) and the Coordination for the Improvement of Higher Education Personnel—CAPES (R.S.S, finance code 001). Figure 3 was created with BioRender.com.
Funding Information:
This work was supported by the S?o Paulo Research Foundation?FAPESP (M.M.G, grant 2016/03248-1) and the Coordination for the Improvement of Higher Education Personnel?CAPES (R.S.S, finance code 001). Figure 3 was created with BioRender.com.
Publisher Copyright:
© 2020 Wiley Periodicals LLC
PY - 2021/10
Y1 - 2021/10
N2 - Background: Despite the well-known role of programmed cell death ligand 1 (PD-L1) in promoting immune resistance in oral squamous cell carcinoma (OSCC), its potential utility as a prognostic biomarker is undetermined. We evaluated PD-L1 expression as predictor of survival in patients with OSCC and explored PD-L1 expression patterns. Methods: We conducted a retrospective cohort study that assessed PD-L1 expression through immunohistochemistry in 123 surgical specimens of OSCC. A first approach evaluated tumor proportion scores (TPS) and combined proportion scores (CPS). Next, expression patterns were examined by evaluating PD-L1 localization in tumor nests, as well as the interfaces of tumor cells (TC) and immune cells (IC) in the tumor microenvironment. Results: High-level PD-L1 expression determined by TPS and CPS using variable cutoffs was not associated with survival. Immunohistochemistry revealed that TC expressed PD-L1 in either patchy or diffuse patterns. The patchy pattern was an independent risk factor for overall survival. Furthermore, expression patterns in the tumor immune microenvironment showed that most cases expressed PD-L1 on both TC and IC, while PD-L1 non-expressors had the lowest overall survival. Conclusion: PD-L1 expression patterns in the context of localization in tumor nests and TC—IC interactions represent antitumor immune responses better than either TPS or CPS. Our suggested classification system may have important implications for the characterization of OSCC and for the use of PD-L1 as a prognostic biomarker.
AB - Background: Despite the well-known role of programmed cell death ligand 1 (PD-L1) in promoting immune resistance in oral squamous cell carcinoma (OSCC), its potential utility as a prognostic biomarker is undetermined. We evaluated PD-L1 expression as predictor of survival in patients with OSCC and explored PD-L1 expression patterns. Methods: We conducted a retrospective cohort study that assessed PD-L1 expression through immunohistochemistry in 123 surgical specimens of OSCC. A first approach evaluated tumor proportion scores (TPS) and combined proportion scores (CPS). Next, expression patterns were examined by evaluating PD-L1 localization in tumor nests, as well as the interfaces of tumor cells (TC) and immune cells (IC) in the tumor microenvironment. Results: High-level PD-L1 expression determined by TPS and CPS using variable cutoffs was not associated with survival. Immunohistochemistry revealed that TC expressed PD-L1 in either patchy or diffuse patterns. The patchy pattern was an independent risk factor for overall survival. Furthermore, expression patterns in the tumor immune microenvironment showed that most cases expressed PD-L1 on both TC and IC, while PD-L1 non-expressors had the lowest overall survival. Conclusion: PD-L1 expression patterns in the context of localization in tumor nests and TC—IC interactions represent antitumor immune responses better than either TPS or CPS. Our suggested classification system may have important implications for the characterization of OSCC and for the use of PD-L1 as a prognostic biomarker.
KW - expression pattern
KW - immune microenvironment
KW - oral cancer
KW - programmed cell death ligand 1
KW - score
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U2 - 10.1111/odi.13714
DO - 10.1111/odi.13714
M3 - Article
C2 - 33169454
AN - SCOPUS:85096801909
SN - 1354-523X
VL - 27
SP - 1699
EP - 1710
JO - Oral Diseases
JF - Oral Diseases
IS - 7
ER -