Prognostic significance of programmed death-1 and programmed death-ligand 1 expression in patients with esophageal squamous cell carcinoma

Kaiyan Chen, Guoping Cheng, Fanrong Zhang, Nan Zhang, Dan Li, Jiaoyue Jin, Junzhou Wu, Lisha Ying, Weimin Mao, Dan Su, Kaiyan Chen, Guoping Cheng, Fanrong Zhang, Nan Zhang, Dan Li, Jiaoyue Jin, Junzhou Wu, Lisha Ying, Weimin Mao, Dan Su

Abstract

Aims: To evaluate the expression of programmed death-1 (PD-1) and programmed death-ligand 1 (PD-L1) and their clinical and prognostic significance in primary esophageal squamous cell carcinoma (ESCC).

Results: The expression rate of PD-1 and PD-L1 in ESCC was 33.5% (117/349) and 41.4% (222/536), respectively. PD-L1 expression differed significantly by tumor location, grade, lymph node metastases, and disease stage (P < 0.05). Moreover, its expression was associated with the disease free survival (DFS). Patients with positive PD-L1 expression had reduced risk for disease relapse compared to those without PD-L1 expression (Hazard ratio [HR] = 0.75, 95% confidence interval [CI]: 0.56-1.00, P = 0.048). Kaplan-Meier curves showed the similar result, P = 0.047. However, there was no significant correlation between PD-1 expression and clinicopathological factors or outcome in ESCC (P > 0.05).

Methods: The expression of PD-1 and PD-L1 was assessed by immunohistochemistry on tissue microarrays from 536 primary ESCC who underwent surgery during January 2008 and April 2012 in Zhejiang Cancer Hospital. Chi-square test and Cox proportional hazards regression were employed to analyze the associations between their expressions and clinicopathological variables and survival.

Conclusions: Our results suggested that PD-L1 could be a favorable indicator of prognosis in ESCC.

Keywords: PD-1; PD-L1; esophageal cancer; immunochemistry; prognosis.

Conflict of interest statement

No potential conflicts of interest were disclosed.

Figures

Figure 1. PD-1 and PD-L1 expression in…
Figure 1. PD-1 and PD-L1 expression in ESCC by immunohistochemistry staining
(A) Negative expression of PD-L1. (B) Positive expression of PD-L1. (C) Negative expression of PD-1. (D) Positive expression of PD-1. Original magnification ×200.
Figure 2. Kaplan-Meier curves of DFS and…
Figure 2. Kaplan-Meier curves of DFS and OS in ESCC based upon PD-1 and PD-L1 expression
Patients with PD-L1 expression had significantly longer DFS than those without PD-L1 expression (median DFS: not reached verse 41.3 months, P = 0.047, (A). There was no statistically significant difference in OS between the patients with positive and negative PD-L1 staining (median OS: 57.6 verse 41.3 months, P = 0.218, (B). PD-1 expression was not significantly correlated with DFS or OS in ESCC (P > 0.05, (C and D).

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