PD-L1 Expression in Colorectal Carcinoma: Immunohistochemical Study
DOI:
https://doi.org/10.21276/apalm.2742Keywords:
Colorectal Carcinoma, PD-L1, Tumor infiltrating lymphocytesAbstract
Background : Colorectal carcinoma is the most common type of GIT malignancy which is a multifactorial process with etiology encompassing genetic factors, environmental exposures and inflammatory conditions of the digestive tract.
Method: 40 histologically proven cases of colorectal carcinoma were subjected for IHC expression of PD-L1 using Biocare kit. PD-L1 was taken positive as yellow to brown particles in membrane, cytoplasm or both. It was graded depending upon staining intensity and percentage of the cells and scoring was done by multiplying both and ≥ 3 was taken as positive score.
Result : Most of the cases were in 6th and 7th decade of life (62.5%) with M:F ratio being 1.4:1. Most common site involved was rectum. Histologically 29 cases were conventional adenocarcinoma with rest being mucinous and mucin secreting type and most of them being moderately differentiated (70%). On immunohistochemistry, PD-L1 expression was seen in 20 cases with moderate and strong intensity. But PD-L1 score was positive in 14 cases (35%). TIL was positive in 57.5% of the cases. Statistically there was significant correlation between histological type of tumor with PD-L1 (p value=0.03) and TIL (p value=0.017). Although PD-L1 positivity was insignificant with histological differentiation (p value=0.65) but TIL was significant (p value=0.03).
Conclusion : PD-L1 expression is relevant to the prognosis as well as for further CRC therapies whereas the TIL cell positivity has become an independent predictor of patients survival.
References
2. Wong M, Ding H, Wang J, Chan P, Huang J. Prevalence and Risk Factors of Colorectal Cancer in Asia. Intest Res. 2019;17(3):317-29
3. Arnold M, Sierra MS, Laversanne M, Soerjomataram I, Jemal A, Bray F. Global patterns and trends in Colorectal Cancer Incidence and Mortality. Gut. 2017 Apr;66(4):683-91
4. Parkin D, Pisani P, Ferlay J. Global Cancer Statistics. Int J Cancer. 1999 Jan;80(1):33– 64.
5. American Cancer Society. Colorectal Cancer Facts & Figures 2017-2019 [Internet]. Atlanta: American Cancer Society; 2017. Available form: https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/colorectal-cancer-facts-and-figures/colorectal-cancer-facts-and-figures-2017-2019.pdf
6. Locker GY, Hamilton S, Harris J. ASCO 2006 update of recommendations for the use of tumor markers in gastrointestinal cancer. J Clin Oncol. 2006 Nov;24(11):5313-27.
7. Wu Y, Chen W, Xu ZP, Gu W. PD-L1 Distribution and perspective for cancer immunotherapy- Blockade, Knockdown, or Inhibition. Front Immunol. 2019 Aug;10:2022
8. Wang X, Teng F, Kong L, Yu J. PD-L1 Expression in Human Cancers and Its Association with Clinical Outcomes. OncoTargets and Therapy. 2016;9:5023-39.
9. Lou J, Zhou Y, Huang J, Qian X. Relationship between PD-L1 expression and clinical characteristics in patients with breast invasive ductal carcinoma. Open Med (Wars) [Internet]. 2017 Sep [cited 2017 Nov];12:288-92. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5588755/ DOI: 10.1515/med-2017-0042.
10. Gasser M, Koenigshausen M, Grimm MR, Stein C, Grimmig T, et al. Clinical Significance and Therapeutic Potential of the Programmed Death Ligand-1 (PD-L1) and PD-L2 Expression in Human Colorectal Cancer. Cancer Sci Ther. 2017 Aug;9:566-73.
11. Li Y, Liang L, Dai W, Cai G, Xu Y, Li X, et al. Prognostic impact of PD-1 and PD-L1 expression in cancer cells and tumour infiltrating lymphocytes in colorectal cancer. Mol Cancer. 2016 Aug;15(1):55
12. White A, Ironmonger L, Steele RJ, Ormiston-Smith N, Crawford C, Seims A. A review of sex-related differences in colorectal cancer incidence, screening uptake, routes to diagnosis, cancer stage and survival in the UK. BMC cancer. 2018;18:906.
13. Shen Z, Gu L, Mao D, Chen M, Jin R. Clinicopathological and Prognostic Significance of PD-L1 Expression in Colorectal Cancer: a Systematic Review and Meta analysis. World J Surg Oncol. 2019 Jan;17:4.
14. Rosenbaum MW, Bledsoe JR, Oyarvide VM, Huynh T, Gand Kenudson MM. PD-L1 expression in colorectal cancer is associated with microsatellite instability, BRAF mutation, medullary morphology and cytotoxic tumor-infiltrating lymphocytes. Mod Pathol. 2016 Sep;29(9):1104-12.
15. Kim JH, Park HE, Cho N, Lee SH, Kang GH. Characterisation of PDL-1 positive subsets of microsatellite unstable colorectal cancers. Br J Cancer. 2016 Jul;115:490-96
16. Inaguma S, Lasota J, Wang Z, Felisiak-Golabek A, Ikeda H, Miettinen M. Clinicopathologic profile, immunophenotype, and genotype of CD274(PDL-1)- positive colorectal carcinomas. Mod Pathol. 2017 Feb;30(2):278-85.
17. Sharma D, Singh G. Clinico-pathological profile of colorectal cancer in first two decades of life: A retrospective analysis from tertiary health center. Indian J Cancer 2017;54:397-400.
18. Fleming M, Ravula S, Tatishchev FL, Wang HL. Colorectal carcinoma: Pathological aspects. J Gastrointest Oncol. 2012 Sep;3(3):153–73.
19. Manxhuka-Kerliu S, Telaku S, Ahmetaj H, Baruti A, Loxha S, Kerliu A. Colorectal cancer: prognostic values. Bosn J Basic Med Sci. 2009;9(1):19-24
20. Valentini AM, Pinto FD, Cariola F, Guerra V, Gianluigi G, Caruso ML et al. PDL-1 expression in colorectal cancer defines three subsets of tumour immune microenvironments. Oncotarget. 2018 Feb; 9(9): 8584-96.
21. Boland CR, Goel A. Microsatellite instability in colorectal cancer. Gastroenterology. 2010 Jun; 138(6):2073-87.
22. Yaghoubi N, Soltani A, Ghazvini K, Hassanian SM, Hashemy SI. PD-1/PDL-1 blockade as a novel treatment for colorectal cancer. Biomedicine and Pharmacotherapy. 2019;110:312-8.
23. Jacobs J, Smits E, Lardon F, Pauwels P, and Deschoolmeester V. Immune Checkpoint Modulation in Colorectal Cancer: What’s New and What to Expect .J Immunol Res. 2015 Oct;2015:158038
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