Expression of PD-L1 and HLA Class I in Esophageal Squamous Cell Carcinoma: Prognostic Factors for Patient Outcome

Shuhei Ito, Shinji Okano, Masaru Morita, Hiroshi Saeki, Satoshi Tsutsumi, Hiroshi Tsukihara, Yuichiro Nakashima, Koji Ando, Yu Imamura, Kippei Ohgaki, Eiji Oki, Hiroyuki Kitao, Koshi Mimori, Yoshihiko Maehara

Research output: Contribution to journalArticlepeer-review


BACKGROUND: Programmed cell death 1 ligand 1 (PD-L1) and human leukocyte antigen (HLA) class I molecules on malignant cell surfaces are pivotal for tumor immunity. The clinical significance of their expression in patients with esophageal squamous cell carcinoma (ESCC) remains to be determined.

METHODS: PD-L1 and HLA class I protein expression was investigated by immunohistochemical staining of resected specimens from 90 ESCC patients who underwent radical surgery without preoperative therapy. The relationships between the expression of PD-L1 and HLA class I and clinicopathologic factors and patient prognosis were assessed.

RESULTS: High expression of PD-L1 and HLA class I were observed in 17 (18.9 %) and 35 (38.9 %) of 90 cases, respectively. High PD-L1 expression was correlated with the depth of tumor invasion (P = 0.0379), lymph node metastasis (P = 0.0031), recurrence (P = 0.0085), and poor overall survival (OS) (5-year survival rate; low/high: 60.9/28.4 %, P = 0.0110). Among those patients with high expression of HLA class I, high PD-L1 expression was correlated with significantly poorer recurrence-free survival (median survival time, low/high: 102.5/3.1 months, P = 0.0016) and poorer OS (median survival time, low/high: 102.5/13.1 months, P = 0.0027). Multivariate analysis showed that combined high PD-L1/high HLA class I expression was an independent prognostic factor for recurrence-free survival (hazard ratio 2.88, 95 % confidence interval 1.02-7.04, P = 0.0455) and OS (hazard ratio 2.95, 95 % confidence interval 1.03-7.50, P = 0.0447).

CONCLUSIONS: High PD-L1 expression was a significant independent prognostic factor in ESCC patients with high HLA class I expression.

Original languageEnglish
Pages (from-to)508-515
Number of pages8
JournalAnnals of Surgical Oncology
Issue numberSuppl 4
Publication statusPublished - Aug 2016


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