細胞程序死亡配體1(PDL1)在上泌尿道上皮癌的預測角色
蔡牧堯1、陳建旭1、江品葭1、江博暉1、宋明澤2、羅浩倫1
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 prognostic factor of PDL-1 in Upper tract urothelial carcinoma
Mu-Yao Tsai1, Chien-Hsu Chen1, Pin-Chia Chiang1, Po-Huei Chiang1, Ming-Tse Sung2, Hao-Lun Luo1
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) expression in UTUC in Taiwan and to survey prognostic value of PD- L1 expression in upper tract urothelial carcinoma varies according to clinicopathologic parameters.
Materials and Methods: We retrospectively reviewed the patients with UTUC treated at our institute from 2013-2018. One hundred and thirty-four UTUC specimens were evaluated for PD-L1 expression on representative whole tissue sections using the combined positive score (CPS; Dako 22C3 pharmDx assay). The CPS ≥ 10% was considered positive.
Results: Among 134 cases, 23.9% of UUC cases were positive PD-L1 expression, The CPS ≥ 10% was significantly associated with advanced tumor stage (≥ T3), lymph node invasion and metastasis at diagnosis. On univariate analysis, CPS ≥ 10% was associated with cancer specific survival and overall survival. On multivariate analysis, CPS was an independent prognosticator of cancer-specific survival (HR 3.84, 95% CI 1.70-8.65) but not overall survival.
Conclusions: PD-L1 CPS ≥ 10% in UTUC was associated with adverse pathological features and independently predicted shorter cancer specific survival.