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KMID : 1137020170280060005
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Journal of Gynecologic Oncology
2017 Volume.28 No. 6 p.5 ~ p.5
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Prognostic value of programmed death-ligand 1 (PD-L1) expression in ovarian clear cell carcinoma
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Zhu Jun
Wen Hao
Bi Rui
Wu Yong
Wu Xiao Hua
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Abstract
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Objective: Programmed death-ligand 1 (PD-L1) was expressed in various tumors and antibodies targeting its receptor programmed cell death-1 (PD-1) are emerging cancer therapeutics. This study was designed to evaluate the expression of PD-L1 and its correlation with clinicopathologic features and clinical outcomes in ovarian clear cell carcinoma (OCCC).
Methods: The PD-L1 expression was measured by tissue-microarray-based immunohistochemistry from 122 eligible patients diagnosed with OCCC. The associations of clinicopathologic features with progression-free survival (PFS) and overall survival (OS) were analyzed by Kaplan-Meier method and multivariate analysis was further performed by Cox regression model.
Results: Overall, high PD-L1 expression (PD-L1high) was observed in 44.7% (55/123) of OCCC patients, and was strongly associated with advanced stages (p=0.020), positive ascitic fluid (p=0.016), platinum-resistant (PR) disease (p=0.045), and recurrence (p=0.038). Moreover, patients with PD-L1high were associated with poorer OS (hazard ratio [HR]=2.877; p=0.001) and PFS (HR=1.843; p=0.021) than those with low PD-L1 expression (PD-L1low). In subgroup analysis, PD-L1high patients experienced a poorer PFS (HR=1.926; p=0.044) and OS (HR=2.492; p=0.021) than PD-L1low cases among advanced stages (III?IV), but this difference was not observed in stage I?II patients. Meanwhile, PD-L1high was associated with poorer prognosis than PD-L1low in PR patients (OS, HR=2.253; p=0.037; PFS, HR=1.448; p=0.233). Multivariate analysis revealed that PD-L1high and advanced stages (III?IV) were adverse independent prognosticators for both PFS (HRPD-L1=2.0; pPD-L1=0.038; HRstage=10.2; pstage<0.001) and OS (HRPD-L1=3.0; pPD-L1=0.011; HRstage=14.3; pstage<0.001).
Conclusion: PD-L1high might serve as a risk factor for PFS and OS in patients with OCCC. It is possible that immunotherapy targeting PD-L1 pathway could be used in OCCC.
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KEYWORD
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Ovarian Neoplasms, Adenocarcinoma, Clear Cell, Antigens, CD274, Prognosis
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