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Cancers 2018, 10(10), 374; https://doi.org/10.3390/cancers10100374

Low PD-L1 Expression Strongly Correlates with Local Recurrence in Epstein-Barr Virus-Positive Nasopharyngeal Carcinoma after Radiation-Based Therapy

1
Department of Pathology, Chang Gung Memorial Hospital and Chang Gung University, 5 Fusing Street, Gueishan, Taoyuan 333, Taiwan
2
Department of Radiation Oncology, Chang Gung Memorial Hospital and Chang Gung University, 5 Fusing Street, Gueishan, Taoyuan 333, Taiwan
3
Chang Gung Molecular Medicine Research Center, Chang Gung University, 259 Wenhua First Road, Gueishan, Taoyuan 333, Taiwan
4
Tissue Bank, Chang Gung Memorial Hospital, 5 Fusing Street, Gueishan, Taoyuan 333, Taiwan
5
Center for Vascularized Composite Allotransplantation, Chang Gung Memorial Hospital, 5 Fusing Street, Gueishan, Taoyuan 333, Taiwan
*
Author to whom correspondence should be addressed.
Received: 11 September 2018 / Revised: 5 October 2018 / Accepted: 8 October 2018 / Published: 9 October 2018
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Abstract

The prognostic value of programmed death-ligand 1 (PD-L1) expression in nasopharyngeal carcinoma (NPC) is controversial, with previous studies showing conflicting results. Most NPCs in endemic areas are Epstein-Barr virus (EBV)-positive. Our aim was to evaluate the clinical significance of PD-L1 expression in EBV-positive NPC. We retrospectively analyzed PD-L1 expression on tumor cells (TCs) and immune cells (ICs) by immunohistochemistry in 208 EBV-positive NPC patients who underwent radiotherapy (203 with concurrent chemotherapy). The percentages of TCs and ICs expressing PD-L1 were evaluated respectively. There was a strong correlation between local recurrence and low PD-L1 expression on ICs (p = 0.0012), TCs (p = 0.013) or both (p = 0.000044), whereas all clinical parameters had no influence on local recurrence. Using multivariate analysis, low PD-L1 expression on ICs was an independent adverse prognostic factor (p = 0.0080; HR = 1.88; 95% CI = 1.18–3.00) for disease-free survival. High PD-L1 expression on both ICs and TCs was an independent favorable prognostic factor (p = 0.022; HR = 0.46; 95% CI = 0.24–0.89) for overall survival. We show for the first time that low PD-L1 expression on ICs and TCs strongly correlates with local recurrence in EBV-positive NPC patients after radiation-based therapy. A simple immunohistochemical study for PD-L1 can identify patients prone to local recurrence, and such patients might benefit from more aggressive treatment in future clinical trials. View Full-Text
Keywords: programmed death-ligand 1; nasopharyngeal carcinoma; Epstein-Barr virus; immunohistochemistry; radiotherapy; local recurrence; survival programmed death-ligand 1; nasopharyngeal carcinoma; Epstein-Barr virus; immunohistochemistry; radiotherapy; local recurrence; survival
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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.

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