PD-L1表达在口腔鳞状细胞癌中的预后价值

IF 1.9 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Oral Surgery Oral Medicine Oral Pathology Oral Radiology Pub Date : 2025-07-21 DOI:10.1016/j.oooo.2025.04.021

Wattawan Wongpattaraworakul, Allen Choi, Marisa Buchakjia, Emily Lanzel, Andrean Simons-Burnett, Anand Rajan

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引用次数: 0

摘要

程序性细胞死亡蛋白配体-1 （PD-L1）是一种免疫检查点蛋白。在癌症中，PD-L1的表达抑制免疫控制，导致肿瘤细胞避免免疫破坏。在口腔鳞状细胞癌（OSCC）中，先前的文献显示PD-L1在研究中的预后价值存在冲突，这可能是由于抗体克隆不同、评分方法不同以及阳性表达的定义不同。此外，PDL1可以在免疫细胞和癌细胞上表达。细胞阳性的分布在不同的OSCC病例中是不同的。在这里，我们的目标是使用fda批准的抗体和相关推荐的评分标准来评估PD-L1表达在OSCC中的预后作用。我们还根据阳性细胞的定位评估了PDL1的预后意义。方法采用抗体克隆22C3 pharmDx和联合阳性评分（CPS）标准，采用免疫组化方法分析含有347个OSCC的组织芯片中PD-L1的表达。不同的PD-L1表达截止点用于评估无进展（PFS）和总患者生存期（OS）。生存结果采用Kaplan-Meier图和log-rank检验进行分析。结果spd - l1的表达对手术和放疗患者的生存无影响。然而，在单纯手术治疗的OSCC中，CPS≥70的OSCC与更差的PFS相关。有趣的是，不考虑CPS，仅在癌细胞上具有PDL1阳性的OSCC也与不良PFS相关。即使在PDL1 <；70，如果PDL1阳性全部或大部分表达在癌细胞上，则PFS与CPS≥70的OSCC一样差。结论用抗pd - l1抗体22C3表达pd - l1并结合相关的CPS评分标准可预测单纯手术的OSCC患者的PFS。此外，PD-L1水平的细胞定位似乎影响PFS：仅在癌细胞中高水平表达似乎预示着较差的预后。

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Prognostic value of PD-L1 expression in oral squamous cell carcinoma

Background

Programmed cell death protein ligand-1 (PD-L1) is an immune checkpoint protein. In cancer, PD-L1 expression inhibits immunological control leading to tumor cells avoiding immune destruction. In oral squamous cell carcinoma (OSCC), previous literature showed conflicting prognostic value of PD-L1 among studies potentially due to different clones of antibody, differences in scoring methods, and definitions of positive expression. Additionally, PDL1 could be expressed both on immune cells and cancer cells. The distribution of the cell positivity is different across different OSCC cases. Here, we aim to evaluate the prognostic role of PD-L1 expression in OSCC using an FDA-approved antibody and the associated recommended scoring criteria. We also evaluated prognostic significant of PDL1 based on the localization of positive cells.

Methods

We analyzed PD-L1 expression by immunohistochemistry in tissue microarrays containing 347 OSCC using antibody clone 22C3 pharmDx and combined positive score (CPS) criteria. Different cutoff points of PD-L1 expression were used to assess progression-free (PFS) and overall patient survival (OS). Survival outcomes were analyzed using Kaplan–Meier plots and log-rank tests.

Results

PD-L1 expression had no impact on survival in patients treated with surgery and radiation. However, in OSCC treated with surgery alone, OSCC with CPS ≥ 70 was associated with worse PFS. Interestingly, regardless of CPS, OSCC with PDL1 positivity exclusively/mostly on cancer cells was also associated with poor PFS. Even in cases with PDL1 < 70, if the PDL1 positivity exclusively/mostly expressed on cancer cells, the PFS is as worse as OSCC with CPS ≥ 70.

Conclusion

PD-L1 expression using anti-PD-L1 antibody (22C3) with the associated CPS scoring criteria can predict PFS in OSCC patients who received surgery alone. Additionally, the cellular localization of PD-L1 levels appears to influence PFS: high levels of expression in cancer cells alone appear to portend a worse prognosis.

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来源期刊

Oral Surgery Oral Medicine Oral Pathology Oral Radiology DENTISTRY, ORAL SURGERY & MEDICINE-

CiteScore

3.80

自引率

6.90%

发文量

1217

审稿时长

2-4 weeks

期刊介绍： Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology is required reading for anyone in the fields of oral surgery, oral medicine, oral pathology, oral radiology or advanced general practice dentistry. It is the only major dental journal that provides a practical and complete overview of the medical and surgical techniques of dental practice in four areas. Topics covered include such current issues as dental implants, treatment of HIV-infected patients, and evaluation and treatment of TMJ disorders. The official publication for nine societies, the Journal is recommended for initial purchase in the Brandon Hill study, Selected List of Books and Journals for the Small Medical Library.