Open Access

Programmed death ligand 1 expression in esophageal cancer following definitive chemoradiotherapy: Prognostic significance and association with inflammatory biomarkers

  • Authors:
    • Yating Tang
    • Guang Li
    • Shan Wu
    • Lingrong Tang
    • Ning Zhang
    • Jinzhao Liu
    • Shuo Zhang
    • Lei Yao
  • View Affiliations

  • Published online on: February 7, 2018     https://doi.org/10.3892/ol.2018.7984
  • Pages: 4988-4996
  • Copyright: © Tang et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Immunotherapy with anti‑programmed cell death protein 1 or programmed death ligand 1 (PD‑L1) agents has demonstrated promising efficacy for the treatment of various types of malignancies. However, the role of PD‑L1 as a tumor prognostic marker remains poorly understood. In the present study, the prognostic value of PD‑L1 expression in esophageal carcinoma (EC) following definitive chemoradiotherapy (CRT) was investigated, and its associations with three systemic inflammation biomarkers, neutrophil‑to‑lymphocyte ratio (NLR), platelet‑to‑lymphocyte ratio (PLR) and lymphocyte-to‑monocyte ratio (LMR) were further explored. A total of 104 patients with non‑metastatic EC, who underwent definitive CRT between January 2009 and December 2012, were retrospectively analyzed. The expression of PD‑L1 was examined by immunohistochemistry and the impact of PD‑L1 expression level on overall survival (OS) was assessed. Furthermore, pretreatment neutrophil, lymphocyte, platelet and monocyte counts were obtained from routine blood tests to calculate the NLR, PLR and LMR. PD‑L1 was overexpressed in EC compared with normal esophageal epithelium, with a positive expression rate of 37.5%. Additionally, patients with positive PD‑L1 expression had a lower NLR than those with negative PD‑L1 expression (P=0.001). On multivariate analysis, the positive staining of PD‑L1 was significantly associated with improved OS (HR, 0.6; 95% CI, 0.372‑0.965; P=0.035). Kaplan‑Meier survival analysis showed a similar result (P=0.009). Additionally, sex (HR, 0.449; 95% CI, 0.229‑0.880; P=0.020), clinical stage III (HR, 2.471; 95% CI, 1.171‑5.212; P=0.018), and receipt of concurrent chemoradiation (HR, 0.590; 95% CI, 0.368‑0.945; P=0.028) were all independent prognostic factors in EC treated with definitive CRT. The correlation of NLR with PD‑L1 expression validated the relevance of immunity and inflammation. In summary, the present study demonstrated that positive PD‑L1 expression is associated with improved survival in patients with EC treated with radical CRT, indicating that PD‑L1 is a promising prognostic marker.
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April-2018
Volume 15 Issue 4

Print ISSN: 1792-1074
Online ISSN:1792-1082

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Spandidos Publications style
Tang Y, Li G, Wu S, Tang L, Zhang N, Liu J, Zhang S and Yao L: Programmed death ligand 1 expression in esophageal cancer following definitive chemoradiotherapy: Prognostic significance and association with inflammatory biomarkers. Oncol Lett 15: 4988-4996, 2018
APA
Tang, Y., Li, G., Wu, S., Tang, L., Zhang, N., Liu, J. ... Yao, L. (2018). Programmed death ligand 1 expression in esophageal cancer following definitive chemoradiotherapy: Prognostic significance and association with inflammatory biomarkers. Oncology Letters, 15, 4988-4996. https://doi.org/10.3892/ol.2018.7984
MLA
Tang, Y., Li, G., Wu, S., Tang, L., Zhang, N., Liu, J., Zhang, S., Yao, L."Programmed death ligand 1 expression in esophageal cancer following definitive chemoradiotherapy: Prognostic significance and association with inflammatory biomarkers". Oncology Letters 15.4 (2018): 4988-4996.
Chicago
Tang, Y., Li, G., Wu, S., Tang, L., Zhang, N., Liu, J., Zhang, S., Yao, L."Programmed death ligand 1 expression in esophageal cancer following definitive chemoradiotherapy: Prognostic significance and association with inflammatory biomarkers". Oncology Letters 15, no. 4 (2018): 4988-4996. https://doi.org/10.3892/ol.2018.7984