关于程序性细胞死亡配体(PD-L)-1和PD-L2在唾液腺癌中的作用的数据有限。我们旨在评估PD-L1和PD-L2表达的预后价值,与免疫机制密切相关,关于唾液腺肿瘤类型和分期。数据来自2006年至2021年之间手术切除的唾液腺肿块患者,诊断为恶性唾液腺肿瘤,进行回顾性分析。对切除材料进行PD-L1和PD-L2的免疫反应性。90例患者的平均年龄为52.1±18.8,男性占46.7%。总的来说,55.6%的患者诊断为腺样囊性癌(ACC),23.3%合并粘液表皮样癌(MEC),16.7%伴有腺泡细胞癌(AciCC),3.3%患有导管癌(DC),1例多形性腺瘤出癌(PA-ex-CA)。总之,52%的ACC,12%的AcCC,24%的MEC,12%的DC病例处于IV期。肿瘤直径,淋巴管浸润的频率,转移,切缘阳性,复发,III期和IV期患者的死亡率明显高于I期和II期患者(P<0.05)。与其他类型肿瘤患者相比,MEC患者PD-L1的肿瘤细胞评分(TCS)和免疫细胞评分(ICS)的百分比明显更高(P=0.0011)。然而,PD-L1的联合评分(CS)百分比和PD-L2的肿瘤细胞评分百分比在肿瘤类型之间具有可比性(P>0.05)。肿瘤分期之间PD-L1评分差异无统计学意义(P>0.05),但对于PD-L2,所有I期患者的PD-L2TCS<1%,而所有II期和III期患者,92%的IV期患者TCS≥1%(P<0.0001)。PD-L1的高表达主要在MEC病例中观察到(P=0.0016),而所有AciCC患者的PD-L1表达水平均较低(P=0.0206)。肿瘤的平均直径,淋巴管浸润率,神经周浸润,转移,切缘阳性,复发,治疗类型,死亡率,根据PD-L1的表达水平,TILs的比率没有显着差异(P>0.05)。根据1%和5%阈值,阴性和阳性PD-L1评分中肿瘤浸润淋巴细胞的百分比相当(P>0.05)。高PD-L1表达在AcCC中很少见,而PD-L1在MEC中表达较高。我们的发现强调了在所有唾液腺肿瘤患者接受免疫疗法之前未来筛查PD-L1和PD-L2的重要性。
There is a limited amount of data on the role of programmed cell death ligand (PD-L) -1 and PD-L2 in salivary gland carcinomas. We aimed to evaluate the prognostic value of PD-L1 and PD-L2 expressions, which are closely related to immune mechanisms, with respect to salivary gland tumor types and stages. Data from patients with salivary gland masses surgically removed between 2006 and 2021, diagnosed with a malignant salivary gland neoplasm, were retrospectively analyzed. Immunoreactivity for PD-L1 and PD-L2 was performed on resection materials. The mean age of 90 patients was 52.1±18.8 and 46.7% were male. Overall, 55.6% of patients were diagnosed with adenoid cystic carcinoma (ACC), 23.3% with mucoepidermoid carcinoma (MEC), 16.7% with acinic cell carcinoma (AciCC), 3.3% with ductal carcinoma (DC), and 1 patient with pleomorphic adenoma ex carcinoma (PA-ex-CA). In all, 52% of ACC, 12% of AciCC, 24% of MEC, and 12% of DC cases were at stage IV. The tumor diameter, frequencies of lymphovascular invasion, metastasis, positive surgical margin, recurrence, and mortality rates of patients at stages III and IV were significantly larger than those at stages I and II ( P <0.05). The percentages of tumor cell score (TCS) and immune cell score (ICS) for PD-L1 were significantly higher among patients with MEC compared with those with other types of tumors ( P =0.0011). However, the percentages of combined score (CS) for PD-L1 and tumor cell score for PD-L2 were comparable among tumor types ( P >0.05). No significant difference was found in these scores for PD-L1 between tumor stages ( P >0.05), but for PD-L2, all patients at stage I had TCS <1% for PD-L2, while all patients at stages II and III, and 92% of patients at stage IV had TCS ≥1% ( P <0.0001). High expression of PD-L1 was mostly observed in MEC cases ( P =0.0016), while all patients with AciCC had a low PD-L1 expression level ( P =0.0206). The mean tumor diameter, rate of lymphovascular invasion, perineural invasion, metastasis, positive surgical margin, recurrence, type of treatment, mortality, and TILs ratio did not differ significantly according to PD-L1 expression level ( P >0.05). The percentage of tumor-infiltrating lymphocytes was comparable among negative and positive PD-L1 scores according to both 1% and 5% threshold values ( P >0.05). High PD-L1 expression is rare in AciCC, while PD-L1 expression is high in MEC. Our findings underline the importance of future screening for PD-L1 and PD-L2 before patients undergoing immunotherapies in all salivary gland tumors.