PD-L1 expression in liver metastasis: its clinical significance and discordance with primary tumor in colorectal cancer
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Journal of Translational Medicine Open Access
RESEARCH
PD‑L1 expression in liver metastasis: its clinical significance and discordance with primary tumor in colorectal cancer Xiao‑Li Wei1†, Xuan Luo2†, Hui Sheng3†, Yun Wang4, Dong‑Liang Chen1, Jia‑Ning Li5, Feng‑Hua Wang1* and Rui‑Hua Xu1,6*
Abstract Background: The outcomes of immune checkpoint inhibitors in cancer patients with liver metastases are poor, which may be related to a different tumor microenvironment in liver metastases from primary tumors. This study was aimed to analyze PD-L1 expression and the immune microenvironment status in liver metastases and compare the differences of PD-L1 expression between primary tumors and liver metastases of colorectal cancer. Methods: 74 cases of pathologically confirmed colorectal cancer with liver metastasis underwent resection from our hospital were included. Tissue microarrays were used for the interpretation of PD-L1 expression, cluster of differentia‑ tion 4 (CD4) and CD8 density by immunohistochemistry. We evaluated the disparity between primary tumor and liver metastasis in PD-L1 expression, CD4 and CD8 density and analyzed the factors associated with obvious PD-L1 disparity. Results: The expression of PD-L1 was positively related to the density of CD4 and CD8 in liver metastases. The expression of PD-L1 in liver metastases was higher than in primary tumors in certain subgroups, including patients with concurrent liver metastases (n = 63, p = 0.05), patients receiving concurrent resection of primary and metastatic tumors (n = 56, p = 0.04). The two subgroups generally reflected those without inconsistent external influences, such as treatment and temporal factors, between primary tumors and liver metastases. In these subgroups, the intrinsic dif‑ ferences of microenvironment between primary tumors and liver metastases could be identified. Furthermore, tumor differentiation [moderate vs. poor: OR = 0.23, 95% CI: 0.03–0.99, p = 0.05)] were demonstrated to be associated with obvious discordance of PD-L1 expression between primary tumors and liver metastases. Conclusions: The expression of PD-L1 in liver metastases was higher than in primary tumors in subgroups, reflect‑ ing intrinsic microenvironment differences between primary and metastatic tumors. Obvious discordance of PD-L1 expression between primary tumor and liver metastasis was significantly related to the tumor differentiation. Keywords: PD-L1, Liver metastases, Primary tumor, Colorectal cancer
*Correspondence: [email protected]; [email protected] † Xiao-Li Wei, Xuan Luo and Hui Sheng contributed equally to this study 1 Department of Medical Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 Dong Feng Road East, Guangzhou 510060, Guangdong, China Full list of author information is available at the end of the article
Background In recent years, the use of immune checkpoint inhibitors offered new hopes for cancer treatment [1]. With the use of
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