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Am J Clin Pathol. 2019 May 3;151(6):561-573. doi: 10.1093/ajcp/aqz002.

PD-L1 Expression Reveals Significant Association With Squamous Differentiation in Upper Tract Urothelial Carcinoma.

Author information

1
Department of Pathology and Laboratory Medicine, Temple University Hospital, Philadelphia, PA.
2
Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia.
3
Department of Molecular and Cell Biology, University of California, Berkeley.
4
Department of Urology, Hospital of the University of Pennsylvania, Philadelphia.

Abstract

OBJECTIVES:

Limited literature is available on the tumor microenvironment (TM) of upper tract urothelial carcinoma (UTUC). This study comprehensively reviews programmed death 1 receptor (PD-1)-positive and CD8+ tumor-infiltrating lymphocytes (TILs) and programmed death ligand 1 (PD-L1) expression on tumor epithelium (TE).

METHODS:

Seventy-two nephroureterectomy specimens were analyzed for PD-L1, PD-1, and CD8. One percent or more tumor and lymphohistiocyte PD-L1 expression was considered positive. TIL density by H&E was scored semiquantitatively from 0 to 3, and CD8+ and PD-1+ TILs were quantified in hotspots.

RESULTS:

Of the cases, 37.5% demonstrated PD-L1+ on TE. PD-L1+ TE showed an association with pathologic stage (P = .01), squamous differentiation (SqD) (P < .001), TILs by H&E (P = .02), PD-1+ peritumoral TILs (P = .01), and PD-L1+ peritumoral lymphohistiocytes (P = .002). Finally, there was a significant difference in PD-1+ peritumoral TILs in cases with SqD vs no SqD (P = .03).

CONCLUSIONS:

Aggressive UTUC is associated with a distinct TM. Furthermore, TM of UTUC-SqD was distinctly different from those with no SqD, warranting study in a larger cohort.

KEYWORDS:

PD-L1; Tumor microenvironment; Upper tract urothelial carcinoma

PMID:
30776071
DOI:
10.1093/ajcp/aqz002
[Indexed for MEDLINE]

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