Abstract
Background
Programmed cell death 1 (PD-1) and its ligands (PD-L1) play a major role in the immune responses of a variety of cancers.
Objectives
To investigate the expression of PD-L1 in different progression forms of cutaneous squamous cell carcinoma (cSCC) and keratoacanthoma (KA).
Methods
We performed immunohistochemical staining of 21 KA, 26 actinic keratoses (AK), 20 Bowen´s diseases (BD), and 26 high-risk cSCC. The staining patterns were assessed using the tumour proportion score and staining intensity evaluation. Immunohistology scores were statistically analysed.
Results
PD-L1 expression of tumour cells as well as tumour-infiltrating cells (TILs) was significantly higher in KA and cSCC when compared to AK and BD (P = 0.00028 and P = 0.00033, respectively). We observed a very strong positive correlation between the PD-L1 protein expression of tumour cells of KA and the PD-L1 protein expression of TILs (r = 0.97; P < 0.0001). A similar correlation was also found for cSCC (r = 0.86; P < 0.0001). The percentage of PD-L1 + tumours was 33.3% for KA and 26.9% for cSCC. Similarly, the percentage of PD-L1 + TILs in KA and cSCC was 33.3 and 34.6%, respectively.
Conclusions
PD-L1 is differently expressed in cSCC and closely related non-melanoma skin cancer. cSCC exhibit PD-L1 expression in a fourth of cases, indicating that PD1/PD-L1 inhibitors might be beneficial in a proportion of patients with an inoperable or metastatic cSCC. Unlike AK and BD, TILs and tumour cells of KA and cSCC present very similar PD-L1 expression profiles indicating a common immune escape mechanism.
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Abbreviations
- AK:
-
Actinic keratosis
- BD:
-
Bowen´s disease
- cSCC:
-
Cutaneous squamous cell carcinoma
- KA:
-
Keratoacanthoma
- NMSC:
-
Non-melanoma skin cancer
- TPS:
-
Tumour proportion score
- UICC:
-
Union Internationale Contre le Cancer
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Acknowledgements
This work is part of the doctoral thesis of Martha Gnielka.
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Gambichler, T., Gnielka, M., Rüddel, I. et al. Expression of PD-L1 in keratoacanthoma and different stages of progression in cutaneous squamous cell carcinoma. Cancer Immunol Immunother 66, 1199–1204 (2017). https://doi.org/10.1007/s00262-017-2015-x
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DOI: https://doi.org/10.1007/s00262-017-2015-x