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- Title
Scoring systems for PD-L1 expression and their prognostic impact in patients with resectable gastric cancer.
- Authors
Pereira, Marina Alessandra; Ramos, Marcus Fernando Kodama Pertille; Dias, André Roncon; Ribeiro, Renan; Cardili, Leonardo; Zilberstein, Bruno; Cecconello, Ivan; Ribeiro, Ulysses; de Mello, Evandro Sobroza; de Castria, Tiago Biachi
- Abstract
The combined positive score (CPS) and tumor proportion score (TPS) have been developed to evaluate programmed death ligand-1 (PD-L1) expression, especially due to the potential benefit of the targeted therapy. However, the prognostic value of PD-L1 scoring systems in gastric cancer (GC) remains unclear. This study aimed to evaluate PD-L1 expression according to CPS and TPS in curative resected GC patients and its correlation with prognosis. We retrospectively evaluated 284 GC patients who underwent D2-gastrectomy by tissue microarray. PD-L1 expression was analyzed by immunohistochemistry. PD-L1 positivity by CPS and TPS was observed in 45 (15.8%) and 34 (12%) patients, respectively. Larger tumor size (p = 0.028), undetermined Lauren type (p < 0.001), and heavy inflammatory infiltrate (p = 0.009) were associated with CPS-positive GC. TPS-positive were more frequent in patients with larger tumor size (p = 0.004), undetermined type (p < 0.001), moderate/severe inflammatory infiltrate (p = 0.001), total gastrectomy (p = 0.036), and poorly differentiated histology (p = 0.025). No differences were observed in the pT, pN, and pTNM status according to the PD-L1 scores. Both scores were associated with Epstein-Barr virus positivity, microsatellite instability and p53-normal expression. The disease-free survival (DFS) was worse for CPS-negative compared to CPS-positive group (p = 0.052). No difference was observed between TPS-positive and negative groups (p = 0.436). Total gastrectomy, advanced pT status, and CPS-negative were independent factor for worse survival in GC. CPS was an independent prognostic factor for survival and could be used as a prognostic biomarker in patients with resectable GC.
- Subjects
PROGRAMMED cell death 1 receptors; STOMACH cancer; PROGRAMMED death-ligand 1; PROGNOSIS; BIOMARKERS; PROGRESSION-free survival
- Publication
Virchows Archiv: European Journal of Pathology, 2021, Vol 478, Issue 6, p1039
- ISSN
0945-6317
- Publication type
Article
- DOI
10.1007/s00428-020-02956-9