Expression of programmed cell death ligand 1 (PD-L1) in advanced stage EBV-associated extranodal NK/T cell lymphoma is associated with better prognosis.
Programmed cell death 1 (PD-1)/PD-1 ligand 1 (PD-L1) pathway blockade has emerged as a promising strategy for cancer therapy. Extranodal natural killer/T cell lymphoma (ENKTL) is an aggressive disease characterized by a strong association with Epstein-Barr virus (EBV), and chronic EBV infection is known to induce PD-L1 expression. However, the PD-1/PD-L1 pathway status in ENKTL remains elusive. Thus, the expression pattern of PD-1 and PD-L1 was investigated in 73 ENKTL cases, and its clinicopathological features and prognostic significance were analyzed. Most ENKTLs had few PD-1+lymphocytes in the tumor microenvironment. PD-L1 was positive in 56 % (n = 41/73) with a cutoff value of ≥10 % of tumor cells and in 62 % (n = 45/73) with a cutoff value of ≥10 % of total cells including malignant and non-malignant cells. PD-L1 expression on tumor cells was mostly correlated with PD-L1 expression on non-malignant cells. PD-L1 positivity showed no significant relationship with clinicopathological features. However, patients with PD-L1+ENKTL exhibited better 5-year overall survival (OS) and a trend for longer 5-year progression-free survival. Moreover, in the subgroups with clinically advanced parameters including late stage III/IV, higher International Prognostic Index scores of 2-5 or non-upper aerodigestive tract involvement PD-L1 positivity was also associated with favorable OS. PD-L1 expression was the only significant independent predictor for longer OS in patients with advanced stage (III/IV) ENKTL. These results suggest that PD-L1 might be used as a novel prognostic marker.
Department of Pathology, Konkuk University School of Medicine, 120 Neungdong-ro, Hwayang-dong, Gwangjin-gu, Seoul, Republic of Korea.|The Tumor Immunity Medical Research Center, Cancer Research Center, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, Republic of Korea.
Wook Youn
WY
Kim
Department of Pathology, Konkuk University School of Medicine, 120 Neungdong-ro, Hwayang-dong, Gwangjin-gu, Seoul, Republic of Korea.
Ho Young
HY
Jung
Department of Pathology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, Republic of Korea.|The Tumor Immunity Medical Research Center, Cancer Research Center, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, Republic of Korea.
Soo Jeong
SJ
Nam
Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, Republic of Korea.
Tae Min
TM
Kim
Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, Republic of Korea.
Dae Seog
DS
Heo
Department of Pathology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, Republic of Korea.|The Tumor Immunity Medical Research Center, Cancer Research Center, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, Republic of Korea.
Chul-Woo
CW
Kim
Department of Pathology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, Republic of Korea. junarplus@chol.com.|The Tumor Immunity Medical Research Center, Cancer Research Center, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, Republic of Korea. junarplus@chol.com.
Yoon Kyung
http://orcid.org/0000-0003-4024-8791
YK
Jeon
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D060890:B7-H1 Antigen / Q000378:metabolism*; D014408:Biomarkers, Tumor / Q000032:analysis; D016923:Cell Death / Q000502:physiology; D018572:Disease-Free Survival; D020031:Epstein-Barr Virus Infections / Q000175:diagnosis / Q000473:pathology*; D005260:Female; D004854:Herpesvirus 4, Human; D006801:Humans; D054391:Lymphoma, Extranodal NK-T-Cell / Q000175:diagnosis / Q000378:metabolism* / Q000401:mortality / Q000821:virology; D008297:Male; D008875:Middle Aged; D011379:Prognosis
D060890:B7-H1 Antigen; D014408:Biomarkers, Tumor; C423236:CD274 protein, human
EBV; Extranodal NK/T cell lymphoma; Prognosis; Programmed cell death 1; Programmed cell death ligand 1