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The relationship between the PD-L1 expression of surgically resected and fine-needle aspiration specimens for patients with pancreatic cancer



Recently, therapeutic antibodies against programmed death-1/programmed death-ligand 1 (PD-1/PD-L1) have shown promising clinical results for several solid tumors, including pancreatic cancer. In this study, we evaluated the relationship between the PD-L1 expression of surgical resected and fine-needle aspiration (FNA) specimens for patients with pancreatic cancer.


Of 121 patients who underwent endoscopic ultrasound-guided (EUS)–FNA before surgery for pancreatic cancer in an academic center, the 94 (78%) with adequate FNA specimens for a histological evaluation were retrospectively analyzed. All the patients had undergone upfront surgery without any chemotherapy or radiotherapy. We performed immunohistochemistry (IHC) staining to investigate the PD-L1 expression in both resected and FNA specimens. The positive-stained cells were counted, and their percentage was used for the investigation.


Of the 94 patients, 16 (17%) and 11 (10%) were defined as positive on resected cancer specimens using cutoff points of 5% and 10% positively stained cancer cell counts, respectively. The concordance rates for the positive frequency of PD-L1 expression between resected and FNA specimens were 44% (7/16) and 55% (6/11) when the positivity was set to ≥ 5% and ≥ 10%, respectively. The concordance rates for the negative frequency of PD-L1 expression between two specimens were 97% (76/78) and 99% (82/83) when the positivity was set to ≥ 5% and ≥ 10%, respectively.


Approximately, half of the patients with PD-L1 expression positive and almost all the patients with PD-L1 expression negative could be diagnosed on FNA specimens.

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Fig. 3



Programmed death-1


Programmed death-ligand 1


Mismatch repair


High-frequency microsatellite instability




Endoscopic ultrasound


Fine-needle aspiration


Rapid on-site evaluation


Phosphate-buffered saline


Interquartile range


Carcinoembryonic antigen


Carbohydrate antigen 19-9


Duke pancreatic monoclonal antigen type 2


Serum pancreas antigen type 1


Human equilibrative nucleoside transporter 1


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The author are indebted to Dr. Toshiharu Mitsuhashi, Assistant Professor of the Center for Innovative Clinical Medicine of Okayama University Hospital for statistical analyses.


This work was supported by JSPS KAKENHI Grant no. 17K09462.

Author information




KM, TO and AK: conception and design of the research and writing the paper. FM, MT and NT: analysis and interpretation of data. HK and SH: critical revision of the article for important intellectual content. RY, YU and TY: collection of the surgical specimens. SF: performing the external validation for pathological evaluation. MA and HO: final approval of the article. All the authors read and approved the final manuscript.

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Correspondence to Kazuyuki Matsumoto.

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Supplemental figure 1 PD-L1 and HE staining of a resected specimen. The PD-L1 positive cells distributed patchy in the resected whole cancer area. HE (low magnification): A, PD-L1: B, HE (mild magnification): C, PD-L1: D (JPEG 638 kb)

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Matsumoto, K., Ohara, T., Fujisawa, M. et al. The relationship between the PD-L1 expression of surgically resected and fine-needle aspiration specimens for patients with pancreatic cancer. J Gastroenterol 54, 1019–1028 (2019).

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  • PD-L1
  • Pancreatic cancer
  • Immunohistochemistry