Low PD-L1 Expression Strongly Correlates with Local Recurrence in Epstein-Barr Virus-Positive Nasopharyngeal Carcinoma after Radiation-Based Therapy
Abstract
:1. Introduction
2. Results
2.1. PD-L1 Expression and Clinicopathologic Characteristics
2.2. PD-L1 Expression and Local Recurrence-Free Survival
2.3. PD-L1 Expression and Distant Metastasis-Free Survival
2.4. PD-L1 Expression and Disease-free Survival
2.5. PD-L1 Expression and Overall Survival
3. Discussion
4. Materials and Methods
4.1. Patients and Samples
4.2. Evaluation of PD-L1 Expression
4.3. Statistical Analysis
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Characteristic | Total (n = 208) | PD-L1 on TCs | p-Value | PD-L1 on ICs | p-Value | ||
---|---|---|---|---|---|---|---|
Low (n = 101) | High (n = 107) | Low (n = 77) | High (n = 131) | ||||
Pre-treatment | |||||||
Age | |||||||
Mean ± SD | 49 ± 11 | 50 ± 11 | 48 ± 11 | 0.22 | 49 ± 11 | 49 ± 11 | 0.86 |
Median (min; max) | 49 (20; 84) | 49 (25; 84) | 48 (20; 73) | 49 (21; 81) | 49 (20; 84) | ||
Gender | |||||||
Male | 146 (70) | 70 (69) | 76 (71) | 0.79 | 53 (69) | 93 (71) | 0.74 |
Female | 62 (30) | 31 (31) | 31 (29) | 24 (31) | 38 (29) | ||
Smoking | |||||||
Yes | 109 (52) | 58 (57) | 51 (48) | 0.16 | 37 (48) | 72 (55) | 0.33 |
No | 99 (48) | 43 (43) | 56 (52) | 40 (52) | 59 (45) | ||
Alcohol | |||||||
Yes | 56 (27) | 29 (29) | 27 (25) | 0.57 | 23 (30) | 33 (25) | 0.46 |
No | 152 (73) | 72 (71) | 80 (75) | 54 (70) | 98 (75) | ||
Betel quid | |||||||
Yes | 40 (19) | 23 (23) | 17 (16) | 0.21 | 19 (25) | 21 (16) | 0.13 |
No | 168 (81) | 78 (77) | 90 (84) | 58 (75) | 110 (84) | ||
T category | |||||||
T1-2 | 104 (50) | 50 (50) | 54 (50) | 0.89 | 36 (47) | 68 (52) | 0.47 |
T3-4 | 104 (50) | 51 (50) | 53 (50) | 41 (53) | 63 (48) | ||
N category | |||||||
N0-1 | 101 (49) | 49 (49) | 52 (49) | 0.99 | 39 (51) | 62 (47) | 0.64 |
N2-3 | 107 (51) | 52 (51) | 55 (51) | 38 (49) | 69 (53) | ||
M category | |||||||
M0 | 205 (99) | 101 (100) | 104 (97) | 0.27 | 76 (99) | 129 (99) | 1.0 |
M1 | 3 (1) | 0 (0) | 3 (3) | 1 (1) | 2 (1) | ||
AJCC Stage | |||||||
I–II | 55 (26) | 29 (29) | 26 (24) | 0.47 | 22 (29) | 33 (25) | 0.59 |
III–IV | 153 (74) | 72 (71) | 81 (76) | 55 (71) | 98 (75) | ||
Treatment | |||||||
Chemotherapy | |||||||
Yes | 203 (98) | 97 (96) | 106 (99) | 0.33 | 75 (97) | 128 (98) | 1.0 |
No | 5 (2) | 4 (4) | 1 (1) | 2 (3) | 3 (2) | ||
Post-treatment | |||||||
Local recurrence | |||||||
Yes | 32 (15) | 22 (22) | 10 (9) | 0.013 * | 20 (26) | 12 (9) | 0.0012 * |
No | 176 (85) | 79 (78) | 97 (91) | 57 (74) | 119 (91) | ||
Neck recurrence | |||||||
Yes | 34 (16) | 21 (21) | 13 (12) | 0.09 | 15 (20) | 19 (15) | 0.35 |
No | 174 (84) | 80 (79) | 94 (88) | 62 (80) | 112 (85) | ||
Distant metastasis | |||||||
Yes | 35 (17) | 20 (20) | 15 (14) | 0.27 | 18 (23) | 17 (13) | 0.053 |
No | 173 (83) | 81 (80) | 92 (86) | 59 (77) | 114 (87) |
Factor | Hazard Ratio | 95% CI | p-Value | |||
---|---|---|---|---|---|---|
Local recurrence-free survival | ||||||
Univariate analysis | ||||||
PD-L1 (ICs-low vs. ICs-high) | 2.99 | 1.46–6.12 | 0.0028 * | |||
PD-L1 (TCs-low vs. TCs-high) | 2.34 | 1.11–4.95 | 0.026 * | |||
PD-L1 (ICs/TCs both low vs. others) | 3.48 | 1.74–6.98 | 0.00045 * | |||
PD-L1 (ICs/TCs both high vs. others) | 0.33 | 0.13–0.86 | 0.023 * | |||
Age (≥50 years vs. <50 years) | 1.28 | 0.64–2.57 | 0.48 | |||
Gender (male vs. female) | 0.54 | 0.27–1.09 | 0.085 | |||
Smoking (yes vs. no) | 0.70 | 0.35–1.40 | 0.31 | |||
Alcohol drinking (yes vs. no) | 0.87 | 0.39–1.93 | 0.73 | |||
Betel quid chewing (yes vs. no) | 1.00 | 0.41–2.42 | 1.00 | |||
AJCC stage (III–IV vs. I–II) | 1.78 | 0.73–4.32 | 0.21 | |||
T category (T3–4 vs. T1–2) | 1.60 | 0.79–3.23 | 0.20 | |||
N category (N2–3 vs. N0–1) | 1.53 | 0.76–3.10 | 0.24 | |||
M category (M1 vs. M0) | 0.05 | 0–2.0 × 105 | 0.70 | |||
Chemotherapy (yes vs. no) | 0.40 | 0.10–1.66 | 0.21 | |||
Multivariate analysis | ||||||
PD-L1 (ICs-low vs. ICs-high) | 2.74 | 1.33–5.63 | 0.0062 * | |||
PD-L1 (TCs-low vs. TCs-high) | 2.07 | 0.98–4.40 | 0.058 | |||
Disease-free survival | ||||||
Univariate analysis | ||||||
PD-L1 (ICs-low vs. ICs-high) | 1.93 | 1.21–3.07 | 0.0054 * | |||
PD-L1 (TCs-low vs. TCs-high) | 1.55 | 0.97–2.48 | 0.067 | |||
PD-L1 (ICs/TCs both low vs. others) | 2.04 | 1.25–3.33 | 0.0045 * | |||
PD-L1 (ICs/TCs both high vs. others) | 0.53 | 0.31–0.91 | 0.022 * | |||
Age (≥50 years vs. <50 years) | 0.99 | 0.62–1.58 | 0.97 | |||
Gender (male vs. female) | 0.77 | 0.48–1.25 | 0.29 | |||
Smoking (yes vs. no) | 0.78 | 0.49–1.24 | 0.29 | |||
Alcohol drinking (yes vs. no) | 1.40 | 0.86–2.29 | 0.18 | |||
Betel quid chewing (yes vs. no) | 1.91 | 1.14–3.21 | 0.014 * | |||
AJCC stage (III–IV vs. I–II) | 2.40 | 1.26–4.55 | 0.0079 * | |||
T category (T3–4 vs. T1–2) | 1.60 | 1.00–2.56 | 0.050 | |||
N category (N2–3 vs. N0–1) | 1.84 | 1.14–2.96 | 0.013 * | |||
M category (M1 vs. M0) | 0.05 | 0–617 | 0.53 | |||
Chemotherapy (yes vs. no) | 0.96 | 0.24–3.91 | 0.95 | |||
Multivariate analysis | ||||||
PD-L1 (ICs-low vs. ICs-high) | 1.88 | 1.18–3.00 | 0.0080 * | |||
Betel quid chewing (yes vs. no) | 1.68 | 0.99–2.83 | 0.051 | |||
AJCC stage (III–IV vs. I–II) | 2.40 | 1.26–4.58 | 0.0077 * | |||
Overall survival | ||||||
Univariate analysis | ||||||
PD-L1 (ICs-low vs. ICs-high) | 1.51 | 0.90–2.55 | 0.12 | |||
PD-L1 (TCs-low vs. TCs-high) | 1.48 | 0.87–2.51 | 0.15 | |||
PD-L1 (ICs/TCs both low vs. others) | 1.28 | 0.72–2.28 | 0.41 | |||
PD-L1 (ICs/TCs both high vs. others) | 0.46 | 0.24–0.88 | 0.020 * | |||
Age (≥50 years vs. <50 years) | 1.78 | 1.05–3.01 | 0.033 * | |||
Gender (male vs. female) | 0.71 | 0.42–1.22 | 0.22 | |||
Smoking (yes vs. no) | 0.87 | 0.52–1.47 | 0.60 | |||
Alcohol drinking (yes vs. no) | 0.88 | 0.49–1.59 | 0.68 | |||
Betel quid chewing (yes vs. no) | 1.19 | 0.63–2.25 | 0.60 | |||
AJCC stage (III–IV vs. I–II) | 1.83 | 0.95–3.54 | 0.073 | |||
T category (T3–4 vs. T1–2) | 1.72 | 1.01–2.93 | 0.045 * | |||
N category (N2–3 vs. N0–1) | 2.16 | 1.24–3.74 | 0.0063 * | |||
M category (M1 vs. M0) | 2.41 | 0.33–17.5 | 0.39 | |||
Chemotherapy (yes vs. no) | 0.77 | 0.19–3.14 | 0.71 | |||
Multivariate analysis | ||||||
PD-L1 (ICs/TCs both high vs. others) | 0.46 | 0.24–0.89 | 0.022 * | |||
Age (≥50 years vs. <50 years) | 1.80 | 1.06–3.07 | 0.030 * | |||
T category (T3–4 vs. T1–2) | 1.53 | 0.89–2.62 | 0.12 | |||
N category (N2–3 vs. N0–1) | 2.22 | 1.27–3.89 | 0.0052 * |
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Liu, Y.-J.; Tsang, N.-M.; Hsueh, C.; Yeh, C.-J.; Ueng, S.-H.; Wang, T.-H.; Chuang, W.-Y. Low PD-L1 Expression Strongly Correlates with Local Recurrence in Epstein-Barr Virus-Positive Nasopharyngeal Carcinoma after Radiation-Based Therapy. Cancers 2018, 10, 374. https://doi.org/10.3390/cancers10100374
Liu Y-J, Tsang N-M, Hsueh C, Yeh C-J, Ueng S-H, Wang T-H, Chuang W-Y. Low PD-L1 Expression Strongly Correlates with Local Recurrence in Epstein-Barr Virus-Positive Nasopharyngeal Carcinoma after Radiation-Based Therapy. Cancers. 2018; 10(10):374. https://doi.org/10.3390/cancers10100374
Chicago/Turabian StyleLiu, Yu-Jen, Ngan-Ming Tsang, Chuen Hsueh, Chi-Ju Yeh, Shir-Hwa Ueng, Tong-Hong Wang, and Wen-Yu Chuang. 2018. "Low PD-L1 Expression Strongly Correlates with Local Recurrence in Epstein-Barr Virus-Positive Nasopharyngeal Carcinoma after Radiation-Based Therapy" Cancers 10, no. 10: 374. https://doi.org/10.3390/cancers10100374