title: Programmed death-ligand 1 expression in gastric adenocarcinoma is a poor prognostic factor in a high CD8+ tumor infiltrating lymphocytes group.
abstract: Gastric adenocarcinoma is one of the most common causes of cancer-related death. In this study, we conducted immunohistochemical studies for PD-L1, PD-1, CTLA-4, and CD8 using tissue microarrays from 464 gastric cancer samples and evaluated the correlations between their expression, clinicopathologic factors, and five-year overall survival. PD-L1 and PD-1 expression was significantly correlated with several adverse prognostic pathologic factors, including higher T-stage, diffuse Lauren histologic type, and lymphatic invasion. Conversely, CTLA-4 expression was correlated with factors of favorable clinical outcomes. A complete case analysis revealed that high PD-L1 and PD-1 expression had an adverse effect on five-year overall survival in univariate analyses. Subgroup analyses wherein patients were divided into two groups according to CD8+ tumor infiltrating lymphocyte levels (high and low) showed that high PD-L1 expression was a significant adverse prognostic factor only in the high CD8+ tumor-infiltrating lymphocytes group. Further research and clinical trials are needed to determine the clinical usefulness of these findings.
authors.affiliation: Department of Pathology, Korea University Guro Hospital, Korea University College of Medicine, Guro-gu, Seoul, Republic of Korea.
authors.forename: Hyeyoon
authors.initials: H
authors.lastname: Chang
authors.affiliation: Department of Pathology, Catholic Kwandong University International St Mary's Hospital, Incheon, Republic of Korea.
authors.forename: Woon Yong
authors.initials: WY
authors.lastname: Jung
authors.affiliation: Department of Pathology, Green Cross Laboratories, Yongin, Kyeonggi-Do, Republic of Korea.
authors.forename: Youngran
authors.initials: Y
authors.lastname: Kang
authors.affiliation: Department of Pathology, Kangbuk Samsung Hospital, Sungkyunkwan University College of Medicine, Seoul, Republic of Korea.
authors.forename: Hyunjoo
authors.initials: H
authors.lastname: Lee
authors.affiliation: Department of Pathology, Korea University Guro Hospital, Korea University College of Medicine, Guro-gu, Seoul, Republic of Korea.
authors.forename: Aeree
authors.initials: A
authors.lastname: Kim
authors.affiliation: Department of Pathology, Korea University Guro Hospital, Korea University College of Medicine, Guro-gu, Seoul, Republic of Korea.
authors.forename: Han Kyeom
authors.initials: HK
authors.lastname: Kim
authors.affiliation: Department of Pathology, Korea University Guro Hospital, Korea University College of Medicine, Guro-gu, Seoul, Republic of Korea.
authors.forename: Bong Kyung
authors.initials: BK
authors.lastname: Shin
authors.affiliation: Department of Pathology, Korea University Guro Hospital, Korea University College of Medicine, Guro-gu, Seoul, Republic of Korea.
authors.forename: Baek-Hui
authors.initials: BH
authors.lastname: Kim
mesh_terms: D000230:Adenocarcinoma / Q000276:immunology* / Q000401:mortality / Q000473:pathology; D000368:Aged; D060890:B7-H1 Antigen / Q000032:analysis*; D014408:Biomarkers, Tumor / Q000032:analysis*; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology* / Q000473:pathology; D060908:CTLA-4 Antigen / Q000032:analysis; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D016246:Lymphocytes, Tumor-Infiltrating / Q000276:immunology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D061026:Programmed Cell Death 1 Receptor / Q000032:analysis; D016016:Proportional Hazards Models; D013274:Stomach Neoplasms / Q000276:immunology* / Q000401:mortality / Q000473:pathology; D013997:Time Factors; D046888:Tissue Array Analysis
chemical_list: D060890:B7-H1 Antigen; D014408:Biomarkers, Tumor; C423236:CD274 protein, human; D060908:CTLA-4 Antigen; C556706:CTLA4 protein, human; C105992:PDCD1 protein, human; D061026:Programmed Cell Death 1 Receptor
keywords: CTLA-4; PD-1; PD-L1; gastric adenocarcinoma; prognosis