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Overexpression and gene amplification of PD-L1 in cancer cells and PD-L1(+) immune cells in Epstein-Barr virus-associated gastric cancer: the prognostic implications.

癌细胞及EB病毒相关胃癌中PD-L1(+)免疫细胞的PD-L1过表达及基因扩增:预后意义。

Saito R,Abe H,Kunita A,Yamashita H,Seto Y,Fukayama M
阅读:1261 Modern PathologyMar 2017; 30 (3): 316 - 469:427-439 

Abstract

Cancer cells use PD-L1 to evade antitumor immunity through interaction with programmed cell death protein 1 (PD-1) on T cells. Recent whole-genome sequence studies revealed frequent gene amplification of PD-L1 in Epstein-Barr virus-associated gastric cancer (EBVaGC). To investigate the significance of PD-L1 in cancer cells and their microenvironment in EBVaGC, we studied PD-L1 expression by analysis of the public database and immunohistochemistry with fluorescent in situ hybridization (FISH) of the PD-L1 gene. Analysis of the database from The Cancer Genome Atlas also disclosed high expression of PD-L1 in EBVaGC compared with other molecular subtypes of GC. Expression of PD-L1 was frequently detected in cancer cells of EBVaGC (33/96; 34%), with infiltration of PD-L1(+) immune cells in its stroma (43/96; 45%). Both expression of PD-L1 in cancer cells and PD-L1(+) immune cell infiltration in EBVaGC were significantly correlated with diffuse histology according to Lauren's classification and tumor invasion (pT1b or more). As a prognostic indicator, PD-L1 expression in cancer cells correlated with poor outcomes in both overall survival and disease-specific survival (P=0.0498, 0.007). PD-L1-positive cancers had dense infiltration of PD-L1(+) immune cells as well as CD8(+) and PD-1(+) cells in EBVaGC. FISH analysis of representative samples of the tumor demonstrated gene amplification of PD-L1 in 11% of cases. PD-L1-amplified cells corresponded to PD-L1-positive cells showing high-intensity immunohistochemical staining among cancer cells showing weak or moderate intensities. Taken together, PD-L1 expression in cancer cells and their microenvironment may contribute to the progression of EBVaGC, and gene amplification occurs as clonal evolution during progression. This specific subtype of GC infected with EBV is potentially a good candidate for immunotherapy targeting of the PD-L1/PD-1 axis.

摘要

癌细胞可以通过与T细胞上程序性细胞死亡蛋白1(PD-1)相互作用而利用PD-L1逃避抗肿瘤免疫。目前,全基因组测序研究发现在EB病毒相关胃癌(EBVaGC)中PD-L1基因大量扩增。

为了研究PD-L1在癌细胞中的重要性及EB病毒相关胃癌中的微环境,我们通过对公共数据库检索及免疫组织化学法研究了PD-L1的表达,并通过荧光原位杂交法(FISH)研究PD-L1基因。癌症基因组图谱的数据也提示了EB病毒相关胃癌中PD-L1的表达明显高于胃癌的其它分子学亚型。EB病毒相关胃癌中PD-L1的表达比例高(33/96,34%),常伴有PD-L1(+)免疫细胞浸润间质(43/96,45%)。EB病毒相关胃癌中PD-L1的表达及PD-L1(+)免疫细胞浸润与基于Lauren分类的弥漫性组织学类型及肿瘤侵犯密切相关(pT1b或更高)。作为一个预后因素,PD-L1的表达与较差的总体生存率及疾病特异性生存率均相关(P=0.0498, 0.007)。PD-L1阳性的癌症有较多的PD-L1(+)免疫细胞浸润,在EB病毒相关胃癌中也有较多的CD8(+) 细胞和 PD-1(+) 细胞。对典型的肿瘤病例FISH检测发现11%的病例表现出PD-L1基因扩增。相对于癌细胞中PD-L1(+)细胞表现出免疫组织化学强染色,PD-L1扩增的细胞则表现出弱或中等强度的染色。

综上所述,PD-L1在癌症细胞中的表达及其微环境可能会促使EBVaGC的进展,而基因扩增则作为这一过程中的克隆进化。这一感染EB病毒的胃癌特殊亚型可能成为 PD-L1/PD-1 通路靶向免疫疗法不错的候选目标。

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