D-L1與上泌尿道泌尿上皮癌的相關性
蔡牧堯、江品葭、江博暉、羅浩倫、鄭元佐、沈元琦
高雄長庚念醫院 外科部 泌尿科
Programmed death-ligand 1 in Upper urinary tract carcinoma
Mu-Yao Tsai, Ping-Chia Chiang, Po-Huei Chiang, Luo Hao-lun, Yuan-Tzuo Cheng, Yuan-Chi Shen
Divisions of Urology, Department of Surgery, Chang Gung Memorial hospital, Kao Hsiung, Taiwan; Department of Urology
Purpose: Urologic cancer accounted for approximately 10.0% of all the new malignant cases in Taiwan. And, Upper tract urothelial carcinoma(UTUC) in Taiwan is significant higher in western country. It is worth further study for its invasive character and poor clinical outcomes. 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. Microsatellite instability(MSI) stain was also performed to find association between clinical parameters.
Materials and Methods: UTUC cases underwent nephrectomy or ureterectomy from 2013–2017 were retrospectively identified from the surgical pathology database at a single large academic institution. The cohort included 486 cases. PD-L1 immunohistochemistry (IHC) and MSI were performed on representative whole tumor sections. A 1% tumor proportion score(TPS) of PD-L1 expression was regarded as positivity. Association between PD-L1 IHC expression and clinicopathologic parameters will be evaluated, including overall survival rate, cancer-specific survival rate, progression rate, staging, grade, lymphovascular invasion, neutrophil-to-lymphocyte ratio, etc.
Results and current conclusion: There are 63 cases were immunohistochemically examined by tumor PD- L1 expression currently. Approximately 46%(29/63) demonstrated positive PD-L1 expression. Besides, 24 cases were immunohistochemically examined by MSI so far and 8.3%(2/24) was high in MSI expression. This study was a retrospective design which was the main limitation of this study.
Patient summary:
Upper tract urothelial carcinoma indicated poor clinical outcome in Taiwan. Since advanced upper tract urothelial carcinoma had limited treatment options currently, approximately one half of invasive tumors had programmed death-ligand 1 positivity in our study, which was worth to put great emphasis on further investigation of programmed death-ligand 1-based immunotherapeutics in these patients.