PD-L1 Expression Associated with Epstein—Barr Virus Status and Patients’ Survival in a Large Cohort of Gastric Cancer Patients in Northern Brazil
Abstract
:Simple Summary
Abstract
1. Introduction
2. Methods
2.1. Patients and Sample Collection
2.2. Patient’s Follow-Up
2.3. Sample Processing
2.4. Detection of H. pylori and cagA
2.5. EBV Sample Detection
2.6. mRNA Relative Quantification
2.7. Protein Expression Analysis
2.8. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Conflicts of Interest
References
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Variable | No of Patients (%) | p-Value (χ2 Test) |
---|---|---|
Age | ||
<64 years | 618 (61.8) | <0.0001 |
≥64 years | 382 (38.2) | |
Gender | ||
Male | 658 (65.8) | <0.0001 |
Female | 342 (34.2) | |
Stage | ||
I | 143 (14.3) | <0.0001 |
II | 196 (19.6) | |
III | 278 (27.8) | |
IV | 383 (38.3) | |
Presence of Lymph node metastasis | ||
N0 | 103 (10.3) | <0.0001 |
N1 | 265 (26.5) | |
N2 | 314 (31.4) | |
N3 | 318 (31.8) | |
Metastasis | ||
Absent | 487 (48.7) | 0.411 |
Present | 513 (51.3) | |
Histological type * | ||
Diffuse | 412 (41.2) | <0.0001 |
Intestinal | 588 (58.8) | |
Tumor location | ||
Antrum | 238 (28.3) | <0.0001 |
Body | 202 (20.2) | |
Cardia | 312 (31.2) | |
Fundus | 156 (15.6) | |
Pylorus | 28 (2.8) | |
Whole/multiple | 19 (1.9) | |
H. Pylori Urease/PCR | ||
Negative | 172 (17.2) | <0.0001 |
Positive | 828 (82.8) | |
CagA | ||
Negative | 381 (38.1) | <0.0001 |
Positive | 619 (61.9) | |
EBV | ||
Negative | 810 (81.0) | <0.0001 |
Positive | 190 (19.0) |
Clinical Features | Sample Size, (%) | EBV− | EBV+ | p-Value (χ2 Test) | p-Value (Fisher Exact Test) |
---|---|---|---|---|---|
Patients | 1000 | 810 (81.0%) | 190 (19.0%) | ||
Age | |||||
<64 years | 618 (61.8) | 478 (59.0) | 140 (73.7) | <0.0001 *** | <0.0001 *** |
≥64 years | 382 (38.2) | 332 (41.0) | 50 (26.3) | ||
Gender | |||||
Male | 658 (65.8) | 531 (65.6) | 127 (66.8) | 0.737 | 0.403 |
Female | 342 (34.2) | 279 (34.4) | 63 (33.2) | ||
Stage | |||||
I | 143 (14.3) | 108 (13.3) | 35 (18.4) | 0.112 | 0.056 |
II | 196 (19.6) | 155 (19.1) | 41 (21.6) | ||
III | 278 (27.8) | 236 (29.1) | 42 (22.1) | ||
IV | 383 (38.3) | 311 (38.4) | 72 (37.9) | ||
Lymph node metastasis | |||||
N0 | 103 (10.3) | 46 (5.7) | 57 (30.0) | ||
N1 | 265 (26.5) | 222 (27.4) | 43 (22.6) | 0.001 ** | 0.001 ** |
N2 | 314 (31.4) | 266 (32.8) | 48 (25.3) | ||
N3 | 318 (31.8) | 276 (34.1) | 42 (22.1) | ||
Metastasis | |||||
Absent | 487 (48.7) | 360 (44.4) | 127 (66.8) | 0.001 ** | 0.001 ** |
Present | 513 (51.3) | 450 (55.6) | 63 (33.2) | ||
Histological type | |||||
Diffuse | 412 (41.2) | 283 (34.9) | 129 (67.9) | <0.0001 *** | <0.0001 *** |
Intestinal | 588 (58.8) | 527 (65.1) | 61 (32.1) | ||
Tumor location | |||||
Antrum | 238 (28.3) | 242 (29.9) | 41 (21.6) | <0.0001 *** | <0.0001 *** |
Body | 202 (20.2) | 155 (19.1) | 47 (24.7) | ||
Cardia | 312 (31.2) | 227 (28.0) | 85 (44.7) | ||
Fundus | 156 (15.6) | 143 (17.7) | 13 (6.8) | ||
Pylorus | 28 (2.8) | 26 (3.2) | 2 (1.1) | ||
Whole/multiple | 19 (1.9) | 17 (2.1) | 2 (1.1) | ||
Urease/PCR | |||||
Negative | 172 (17.2) | 108 (13.3) | 64 (33.70 | <0.0001 *** | <0.0001 *** |
Positive | 828 (82.8) | 702 (86.7) | 126 (66.3) | ||
CagA | |||||
Negative | 381 (38.1) | 297 (36.7) | 84 (44.2) | 0.054 | <0.05 * |
Positive | 619 (61.9) | 513 (63.3) | 106 (55.8) | ||
mRNA (PD-L1) | |||||
High | 165 (16.5) | 45(5.6) | 165 (86.8) | <0.0001 *** | <0.0001 *** |
Low | 835 (83.5) | 765 (94.4) | 25 (13.2) | ||
Protein (PD-L1) | |||||
High | 194 (19.4) | 0.0 (0.0) | 149 (78.4) | <0.0001 *** | <0.0001 *** |
Low | 806 (80.6) | 810 (100) | 41 (21.6) |
Clinical Features | Sample Size (%) | mRNA (PD-L1) Mean ± SD | p-Value | Protein (PD-L1) Mean ± SD | p-Value |
---|---|---|---|---|---|
All Patients’ | 1000 | ||||
Age | |||||
<64 years | 618 (61.8) | 1.41 ± 0.38 | 0.266 | 1.37 ± 0.33 | 0.050 |
≥64 years | 382 (38.2) | 1.31 ± 0.16 | 1.36 ± 0.47 | ||
Gender | |||||
Male | 658 (65.8) | 1.38 ± 0.33 | 0.609 | 1.39 ± 0.45 | <0.05 |
Female | 342 (34.2) | 1.36 ± 0.29 | 1.34 ± 0.25 | ||
Stage | |||||
I/II | 339 (33.9) | 1.44 ± 0.43 | <0.05 * | 1.42 ± 0.35 | <0.05 * |
III/IV | 661 (66.1) | 1.34 ± 0.25 | 1.34 ± 0.41 | ||
Lymph node metastasis | |||||
N0 | 103 (10.3) | 1.90 ± 0.67 | <0.05 * | 1.79 ± 0.49 | <0.05 * |
N1 | 265 (26.5) | 1.34 ± 0.23 | 1.36 ± 0.58 | ||
N2 | 314 (31.4) | 1.31 ± 0.16 | 1.32 ± 0.19 | ||
N3 | 318 (31.8) | 1.29 ± 0.13 | 1.30 ± 0.17 | ||
Metastasis | |||||
Absent | 487 (48.7) | 1.47 ± 0.45 | <0.001 | 1.45 ± 0.37 | <0.05 * |
Present | 513 (51.3) | 1.28 ± 0.10 | 1.30 ± 0.15 | ||
Histological type | |||||
Diffuse | 412 (41.2) | 1.49 ± 0.45 | <0.05 * | 1.45 ± 0.37 | <0.05 * |
Intestinal | 588 (58.8) | 1.29 ± 0.13 | 1.31 ± 0.39 | ||
Tumor location | |||||
Antrum | 238 (28.3) | 1.32 ± 0.20 | <0.001 ** | 1.31 ± 0.22 | <0.001 ** |
Body | 202 (20.2) | 1.42 ± 0.37 | 1.45 ± 0.30 | ||
Cardia | 312 (31.2) | 1.42 ± 0.38 | 1.41 ± 0.58 | ||
Fundus | 156 (15.6) | 1.33 ± 0.33 | 1.32 ± 0.27 | ||
Pylorus | 28 (2.8) | 1.31 ± 0.16 | 1.38 ± 0.23 | ||
Whole/multiple | 19 (1.9) | 1.25 ± 0.04 | 1.26 ± 0.09 | ||
Urease/PCR | |||||
Negative | 172 (17.2) | 1.51 ± 0.46 | <0.001 ** | 1.46 ± 0.39 | <0.001 ** |
Positive | 828 (82.8) | 1.34 ± 0.28 | 1.35 ± 0.39 | ||
CagA | |||||
Negative | 381 (38.1) | 1.40 ± 0.36 | 0.276 | 1.37 ± 0.31 | 0.449 |
Positive | 619 (61.9) | 1.36 ± 0.30 | 1.37 ± 0.43 | ||
EBV | |||||
Negative | 810 (81.0) | 1.25 ± 0.03 | <0.001 ** | 1.27 ± 0.33 | <0.001 ** |
Positive | 190 (19.0) | 1.90 ± 0.45 | 1.80 ± 0.35 |
Clinical Features | EBV-Negative | EBV-Positive | ||||||||
---|---|---|---|---|---|---|---|---|---|---|
Sample Size | PD-L1 mRNA RQ (Median ± IQR) | p-Value | PD-L1 Protein RQ (Median ± IQR) | p-Value | Sample Size | PD-L1 mRNA RQ (Median ± IQR) | p-Value | PD-L1 Protein RQ (Median ± IQR) | p-Value | |
Age | ||||||||||
<64 years | 478 (59.0) | 1.24 ± 0.30 | <0.001 | 1.23 ± 0.11 | <0.001 | 140 (73.7) | 1.98 ± 0.49 | <0.001 | 1.87 ± 0.36 | <0.001 |
≥64 years | 332 (41.0) | 1.25 ± 0.03 | 1.33 ± 0.49 | 50 (26.3) | 1.68 ± 0.19 | 1.60 ± 0.22 | ||||
Sex | ||||||||||
Male | 531 (65.6) | 1.25 ± 0.03 | 0.719 | 1.28 ± 0.40 | 0.021 * | 127 (66.8) | 1.92 ± 0.47 | 0.774 | 1.82 ± 0.38 | 0.785 |
Female | 279 (34.4) | 1.25 ± 0.03 | 1.24 ± 0.11 | 63 (33.2) | 1.84 ± 0.41 | 1.77 ± 0.28 | ||||
Stage | ||||||||||
I/II | 263 (32.4) | 1.25 ± 0.03 | 0.799 | 1.27 ± 0.13 | 0.124 | 76 (40.0) | 2.09 ± 0.51 | <0.001 | 1.96 ± 0.37 | <0.001 |
III/IV | 547 (67.5) | 1.25 ± 0.03 | 1.27 ± 0.39 | 114 (60.0) | 1.78 ± 0.35 | 1.70 ± 0.30 | ||||
Lymph node metastasis | ||||||||||
N0 | 46 (5.7) | 1.25 ± 0.03 | 0.172 | 1.29 ± 0.13 | 0.110 | 57 (30.0) | 2.42 ± 0.44 | <0.001 | 2.19 ± 0.27 | <0.001 |
N1 | 222 (27.4) | 1.24 ± 0.03 | 1.28 ± 0.59 | 43 (22.6) | 1.81 ± 0.23 | 1.77 ± 0.26 | ||||
N2 | 266 (32.8) | 1.25 ± 0.03 | 1.27 ± 0.14 | 48 (25.3) | 1.63 ± 0.19 | 1.59 ± 0.19 | ||||
N3 | 276 (34.1) | 1.25 ± 0.02 | 1.26 ± 0.13 | 42 (22.1) | 1.61 ± 0.15 | 1.55 ± 0.17 | ||||
Metastasis | ||||||||||
Absent | 360 (44.4) | 1.26 ± 0.03 | 0.561 | 1.26 ± 0.47 | <0.001 | 127 (66.8) | 2.08 ± 0.45 | <0.001 | 1.96 ± 0.32 | <0.001 |
Present | 450 (55.6) | 1.25 ± 0.03 | 1.28 ± 0.14 | 63 (33.2) | 1.54 ± 0.10 | 1.49 ± 0.12 | ||||
Histological type | ||||||||||
Diffuse | 283 (34.9) | 1.25 ± 0.03 | 0.608 | 1.24 ± 0.10 | 0.05 * | 129 (67.9) | 2.03 ± 0.49 | <0.001 | 1.91 ± 0.36 | <0.001 |
Intestinal | 527 (65.1) | 1.25 ± 0.09 | 1.28 ± 0.40 | 61 (32.1) | 1.64 ± 0.19 | 1.58 ± 0.21 | ||||
Tumor location | ||||||||||
Antrum | 242 (29.9) | 1.25 ± 0.04 | <0.001 | 1.24 ± 0.12 | <0.001 | 41 (21.6) | 1.75 ± 0.26 | 0.002 ** | 1.70 ± 0.27 | 0.002 ** |
Body | 155 (19.1) | 1.25 ± 0.03 | 1.32 ± 0.15 | 47 (24.7) | 1.99 ± 0.43 | 1.87 ± 0.31 | ||||
Cardia | 227 (28.0) | 1.25 ± 0.03 | 1.27 ± 0.58 | 85 (44.7) | 1.89 ± 0.48 | 1.78 ± 0.38 | ||||
Fundus | 143 (17.7) | 1.25 ± 0.04 | 1.24 ± 0.11 | 13 (6.8) | 2.29 ± 0.59 | 2.07 ± 0.37 | ||||
Pylorus | 26 (3.2) | 1.26 ± 0.02 | 1.34 ± 0.17 | 2 (1.1) | 1.87 ± 0.27 | 1.87 ± 0.40 | ||||
Whole/multiple | 17 (2.1) | 1.23 ± 0.02 | 1.25 ± 0.09 | 2 (1.1) | 1.36 ± 0.00 | 1.31 ± 0.01 | ||||
PCR urease | ||||||||||
Negative | 108 (13.3) | 1.25 ± 0.03 | 0.186 | 1.23 ± 0.09 | 0.053 | 64 (33.70) | 1.97 ± 0.49 | 0.345 | 1.85 ± 0.40 | 0.314 |
Positive | 702 (86.7) | 1.25 ± 0.03 | 1.27 ± 0.35 | 126 (66.3) | 1.87 ± 0.43 | 1.78 ± 0.32 | ||||
CagA | ||||||||||
Negative | 297 (36.7) | 1.25 ± 0.03 | 0.718 | 1.24 ± 0.11 | <0.05 * | 84 (44.2) | 1.93 ± 0.47 | 0.611 | 1.82 ± 0.37 | 0.481 |
Positive | 513 (63.3) | 1.25 ± 0.03 | 1.29 ± 0.40 | 106 (55.8) | 1.88 ± 0.44 | 1.78 ± 0.33 |
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de Fátima Aquino Moreira-Nunes, C.; de Souza Almeida Titan Martins, C.N.; Feio, D.; Lima, I.K.; Lamarão, L.M.; de Souza, C.R.T.; Costa, I.B.; da Silva Maués, J.H.; Soares, P.C.; de Assumpção, P.P.; et al. PD-L1 Expression Associated with Epstein—Barr Virus Status and Patients’ Survival in a Large Cohort of Gastric Cancer Patients in Northern Brazil. Cancers 2021, 13, 3107. https://doi.org/10.3390/cancers13133107
de Fátima Aquino Moreira-Nunes C, de Souza Almeida Titan Martins CN, Feio D, Lima IK, Lamarão LM, de Souza CRT, Costa IB, da Silva Maués JH, Soares PC, de Assumpção PP, et al. PD-L1 Expression Associated with Epstein—Barr Virus Status and Patients’ Survival in a Large Cohort of Gastric Cancer Patients in Northern Brazil. Cancers. 2021; 13(13):3107. https://doi.org/10.3390/cancers13133107
Chicago/Turabian Stylede Fátima Aquino Moreira-Nunes, Caroline, Cláudia Nazaré de Souza Almeida Titan Martins, Danielle Feio, Isamu Komatsu Lima, Leticia Martins Lamarão, Carolina Rosal Teixeira de Souza, Igor Brasil Costa, Jersey Heitor da Silva Maués, Paulo Cardoso Soares, Paulo Pimentel de Assumpção, and et al. 2021. "PD-L1 Expression Associated with Epstein—Barr Virus Status and Patients’ Survival in a Large Cohort of Gastric Cancer Patients in Northern Brazil" Cancers 13, no. 13: 3107. https://doi.org/10.3390/cancers13133107