Saudi Journal of Pathology and Microbiology (SJPM)
Volume-4 | Issue-07 | 555-563
Original Research Article
Clinicopathological and Prognostic Value of PD-1/PD-L1 Expression in Patients with Breast Cancer
Ghada E Esheba
Published : July 30, 2019
Abstract
Programmed cell death 1 (PD-1), and its ligand programmed cell death-ligand 1 (PD-L1), is important for tumor-immune
escape. Expression PD-L1 was observed in various solid tumors, including breast cancer (BC). The aim of this study is to
examine the expression of PD-1 in tumor infiltrating lymphocytes (TILs) and PD-L1 in tumor cells (TC) in BC cases, to
analyze the association between PD-1 and PD-L1 expression and clinicopathological features, as well as to correlate their
expression with overall survival (OS). This is a retrospective study that was conducted on 110 cases of BC.
Immunohistochemistry was performed to evaluate PD-1 and PD-L1 expression in TILs and TC respectively. There was
no significant association between PD-1expression in TILs and clinicopathological variables. The presence of PD-1+ TIL
was positively associated with PDL-1 expression in tumor cells; however, this association was not statistically significant
(p = 0.062). On the other hand, PD-L1 expression in TC was significantly associated with lymph node involvement (P
<0.0001), advanced stage (P = 0.035), high grade (P <0.0001), high TIL (P = 0.009), and negative ER (P = 0.01). BC
cases with PD-L1 expression had a significantly worse OS (HR = 0.201; 95% CI [0.048 - 0.112], p <0.000). PD-L1
expression was an independent prognostic factor in multivariate analysis (HR = 0.195; 95% CI [0.058 - 0.655], p
=0.008). In conclusion, PD-L1 expression is associated with advanced tumor stage, aggressive subtypes of BC, lymphatic
infiltration, and poor OS in BC.