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KMID : 0371420231050050297
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Annals of Surgical Treatment and Research
2023 Volume.105 No. 5 p.297 ~ p.309
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Prognostic significance of programmed cell death-ligand 1 expression on immune cells and epithelial-mesenchymal transition expression in patients with hepatocellular carcinoma
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Jung Hae-Il
Ahn Hye-In
Oh Mee-Hye
Yun Jong-Hyuk
Lee Hyun-Yong
Bae Sang-Ho
Kim Yung-Kil
Kim Sung-Yong
Baek Moo-Jun
Lee Moon-Soo
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Abstract
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Purpose : Immune checkpoint inhibitors (ICIs) have been shown significant oncological improvements in several cancers. However, ICIs are still in their infancy in hepatocellular carcinoma (HCC). Programmed cell death-ligand 1 (PD-L1), tumor-infiltrating lymphocytes (TILs), and epithelial-mesenchymal transition (EMT) have been known as prognostic factors in HCC. Therefore, we have focused on identifying the molecular mechanisms between each marker to evaluate a predictive role.
Methods : Formalin-fixed paraffin-embedded samples were obtained from 166 patients with HCC who underwent surgery. The expression of PD-L1 and TILs and EMT marker were evaluated by immunohistochemical analysis.
Results : The multivariate analysis showed that TIL expression (hazard ratio [HR], 0.483; 95% confidence interval [CI], 0.269?0.866; P = 0.015) were independent prognostic factors for overall survival. The prognostic factors for disease-free survival were EMT marker expression (HR, 1.565; 95% CI, 1.019?2.403; P = 0.005). Patients with high expression of TILs had significantly better survival compared to patients with low expression (P = 0.023). Patients who were TIL+/EMT? showed a significantly better prognosis than those who were TIL?/EMT+ (P = 0.049).
Conclusion : This study demonstrates that PD-L1 expression of TILs is closely associated with EMT marker expression in HCC. Clinical investigations using anti?PD-1/PD-L1 inhibitors in patients with EMT-associated PD-L1 upregulation are warranted.
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KEYWORD
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Epithelial-mesenchymal transition, Hepatocellular carcinoma, Prognosis, Programmed cell death 1 ligand 2 protein, Tumor-infiltrating lymphocytes
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