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PMID: 33169454 Published · ppublish English Journal Article

PD-L1 expression patterns in oral cancer as an integrated approach for further prognostic classification.

Oral diseases ·Vol. 27 ·No. 7 ·2021-10-00 ·Pages 1699-1710

Miranda-Galvis M, Rumayor Piña A, Sales de Sá R, Almeida Leite A, Agustin Vargas P, Calsavara VF, Lópes Pinto CA, Teng Y, Kowalski LP

Abstract

Despite the well-known role of programmed cell death ligand 1 (PD-L1) in promoting immune resistance in oral squamous cell carcinoma (OSCC), its potential utility as a prognostic biomarker is undetermined. We evaluated PD-L1 expression as predictor of survival in patients with OSCC and explored PD-L1 expression patterns. We conducted a retrospective cohort study that assessed PD-L1 expression through immunohistochemistry in 123 surgical specimens of OSCC. A first approach evaluated tumor proportion scores (TPS) and combined proportion scores (CPS). Next, expression patterns were examined by evaluating PD-L1 localization in tumor nests, as well as the interfaces of tumor cells (TC) and immune cells (IC) in the tumor microenvironment. High-level PD-L1 expression determined by TPS and CPS using variable cutoffs was not associated with survival. Immunohistochemistry revealed that TC expressed PD-L1 in either patchy or diffuse patterns. The patchy pattern was an independent risk factor for overall survival. Furthermore, expression patterns in the tumor immune microenvironment showed that most cases expressed PD-L1 on both TC and IC, while PD-L1 non-expressors had the lowest overall survival. PD-L1 expression patterns in the context of localization in tumor nests and TC-IC interactions represent antitumor immune responses better than either TPS or CPS. Our suggested classification system may have important implications for the characterization of OSCC and for the use of PD-L1 as a prognostic biomarker.

Keywords
expression pattern immune microenvironment oral cancer programmed cell death ligand 1 score
MeSH Terms
B7-H1 Antigen Carcinoma, Squamous Cell Head and Neck Neoplasms Humans Mouth Neoplasms Prognosis Retrospective Studies Tumor Microenvironment
Chemicals
B7-H1 Antigen CD274 protein, human
Authors & Affiliations
9 authors, click to expand affiliations / ORCID
Miranda-Galvis Marisol ORCID
Oral Diagnosis Department, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Brazil. | Department of Oral Biology and Diagnostic Sciences, Dental College of Georgia, Augusta University, Augusta, GA, USA.
Rumayor Piña Alicia
Faculty of Dentistry, Autonomous University of Coahuila, Saltillo, Mexico.
Sales de Sá Raísa
Oral Diagnosis Department, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Brazil.
Almeida Leite Amanda
Oral Diagnosis Department, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Brazil.
Agustin Vargas Pablo
Oral Diagnosis Department, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Brazil.
Calsavara Vinicius Fernando
Department of Epidemiology and Statistics, A.C. Camargo Cancer Center, São Paulo, Brazil.
Lópes Pinto Clóvis A
Department of Anatomic Pathology, A.C. Camargo Cancer Center, São Paulo, Brazil.
Teng Yong
Department of Oral Biology and Diagnostic Sciences, Dental College of Georgia, Augusta University, Augusta, GA, USA. | Georgia Cancer Center, Department of Biochemistry and Molecular Biology, Medical College of Georgia, Augusta University, Augusta, GA, USA.
Kowalski Luiz Paulo ORCID
Oral Diagnosis Department, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Brazil. | Department of Head and Neck Surgery and Otorhinolaryngology, A.C. Camargo Cancer Center, São Paulo, Brazil. | Head and Neck Surgery Department, Medical School, University of São Paulo, São Paulo, Brazil.
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Article Info
Journal
Oral diseases
Abbr.
Oral Dis
ISSN
1601-0825
DOI
10.1111/odi.13714
Published
2021-10-00
Epub
2020-00-26
Pages
1699-1710
Language
English
Region
Denmark
NLM ID
9508565
Grants
São Paulo Research Foundation - FAPESP · 2016/03248-1
Coordination for the Improvement of Higher Education Personnel - CAPES · 001
External Links
PubMed source DOI: 10.1111/odi.13714 View journal details
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