Journal
JOURNAL OF CANCER RESEARCH AND CLINICAL ONCOLOGY
Volume 145, Issue 7, Pages 1785-1794Publisher
SPRINGER
DOI: 10.1007/s00432-019-02942-y
Keywords
Colorectal cancer; Microsatellite instability; PD-L1; Immunotherapy
Categories
Funding
- Taiwan Clinical Oncology Research Foundation
- Ministry of Health and Welfare, Taiwan [MOHW107-TDU-B-211-114019]
- Taipei Veterans General Hospital [107DHA0100381, 108DHA0100103]
- Yen Tjing Ling Medical Foundation [CI-108-19]
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PurposeTo investigate the associations between programmed cell death ligand-1 (PD-L1) on tumor cells (TCs) or PD-L1 on tumor-infiltrating immune cells (TIICs) and the microsatellite instability (MSI) status in colorectal cancer (CRC).MethodsIn total, 238 CRC patients were enrolled. PD-L1 expression and MSI status were studied by immunohistochemical staining and polymerase chain reaction. The (2) test was used to compare characteristics. The Kaplan-Meier method was used for survival analysis. Cox proportional hazards models were used to determine the prognostic influence of clinicopathological factors.ResultsEighteen patients (7.6%) were had MSI-high (MSI-H) CRC. The number of patients with PD-L1 expression on TCs, stromal TIICs and intraepithelial TIICs was 13 (5.5%), 64 (26.9%) and 45 (18.9%), respectively. The MSI-H phenotype was significantly associated with younger age, right sidedness, mucinous component, high grade, stromal TIICs expressing PD-L1 (P=0.042) and intraepithelial TIICs expressing PD-L1 (P<0.001), but not TCs expressing PD-L1. PD-L1-expressing TCs were an independent marker of poor prognosis [hazard ratio (HR)=3.387, P=0.003], and PD-L1-expressing stromal TIICs were an independent marker of good prognosis (HR=0.551, P<0.001).ConclusionsPD-L1-expressing TCs were a marker of poor prognosis; in contrast, PD-L1-expressing TIICs were a marker of good prognosis. The MSI-H phenotype was associated with the presence of PD-L1-expressing TIICs, but not of PD-L1-expressing TCs.
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