細胞程序死亡配體1(PDL1)及Ki-67在上泌尿道上皮癌的預測角色
蔡牧堯1、陳建旭1、江博暉1、黃純真2
高雄長庚紀念醫院 外科部 泌尿科1；高雄長庚紀念醫院 病理科2
The role of PD-L1 and Ki-67 in Upper tract urothelial carcinoma
Mu-Yao Tsai1, Chien-Hsu Chen1, Po-Huei Chiang1, Shun-Chen Huang2
Divisions of Urology, Department of Surgery, Chang Gung Memorial Hospital, Kaohsiung, Taiwan; Department of pathology2, Chang Gung Memorial Hospital, Kaohsiung, Taiwan
Purpose: To evaluate programmed death-ligand 1 (PD-L1) and Ki-67 expression in UTUC in Taiwan and to survey prognostic value of PD- L1 expression and Ki-67 expression in upper tract urothelial carcinoma varies according to clinicopathologic parameters.
Materials and Methods: 501 cases of UTUC from 2013 to 2018 were retrospectively evaluated from the surgical pathology database at a single medical center. The cohort included 102 cases: 11 low-grade, 91 high-grade and pathologic 25 pTa/is, 16 pT1, 21 pT2, 32 pT3 and 8 pT4. PD-L1 immunohistochemistry (IHC) was performed on representative whole tumor sections using 22C3 anti-PD-L1. Combined positive score of tumor and immune cells was reported. We also conducted Ki-67 immunohistochemical stains.
Results: Totally 17.1 %(18 cases) of primary UTUC demonstrated positive (≥10) PD-L1 expression. Besides, there are 72 cases showed Ki-67 ≥ 10% and 49 cases Ki-67≥20% .CPS ≥ 10, Age, Distant metastasis were associated with poor cancer-specific suvrival while CPS ≥ 10, Age, T4, Distant metastasis were poor prognosticators of overall survival.
Conclusions: Ki-67 is not a good prognostic factor in this study. Positive PD-L1 expression highlights the impact of overall survival and provides a rational basis for further investigation.