PD-L1 is remarkably over-expressed in EBV-associated pulmonary lymphoepithelioma-like carcinoma and related to poor disease-free survival
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Wenfeng Fang1,2,*, Shaodong Hong1,2,*, Nan Chen3,*, Xiaobo He3, Jianhua Zhan1,2, Tao Qin1,2, Ting Zhou1,2, Zhihuang Hu1,2, Yuxiang Ma1,2, Yuanyuan Zhao1,2, Ying Tian1,2, Yunpeng Yang1,2, Cong Xue1,2, Yanna Tang3, Yan Huang1,2, Hongyun Zhao1,2, Li Zhang1,2
1State Key laboratory of Oncology in South China, Department of Medical Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, P. R. China
2Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China
3Department of Oncology, the Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, Guangdong, China
*These authors have contributed equally to this work
Li Zhang, e-mail: [email protected]
Keywords: pulmonary lymphoepithelioma-like carcinoma, PD-L1, Epstein–Barr virus
Received: May 07, 2015 Accepted: August 14, 2015 Published: August 24, 2015
Backgroud: Programmed cell death-ligand 1 (PD-L1) and driver mutations are commonly seen in non-small-cell lung cancer (NSCLC). However, the prevelance of PD-L1 over-expression and its prognostic value in Epstein–Barr virus (EBV) associated pulmonary lymphoepithelioma-like carcinoma (LELC) remains poorly understood.
Methods: A total of 214 NSCLC patients and 113 surgically treated pulmonary LELC patients were included. Paraffin-embedded tumor sections were stained with PD-L1 antibody. Correlations between PD-L1 expression and clinicopathological features as well as survival outcomes were analyzed.
Results: The frequency of PD-L1 over-expression in NSCLC was 51.4%. No significant association was observed between common driver mutations and PD-L1 over-expression. Remakably, the positive rate of PD-L1 in pulmonary LELC was 74.3%. High PD-L1 expression was associated with impaired diseas-free survival (DFS) compared with low PD-L1 expression (p = 0.008). Multivariate analysis shows that PD-L1 expression level, N stage and M stage were independent prognostic factors for DFS. N stage and M stage but not PD-L1 expression level were significantly associated with overall survival (OS).
Conclusions: PD-L1 over-expression was not related to common driver mutations in NSCLC. Pulmonary LELC have remarkably high incidence of PD-L1 expression. PD-L1 was a negative prognostic factor for DFS in surgically resected pulmonary LELC. These findings may provide a rationale for immunotarget therapy in this virus-associated lung cancer.
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