J Pathol Transl Med.  2021 Nov;55(6):388-397. 10.4132/jptm.2021.08.04.

Immunohistochemical expression of programmed death-ligand 1 and CD8 in glioblastomas

• Samman DME
• Mahdy MME
• Cousha HS
• Kamar ZAER
• Mohamed KAK
• Gabal HHA

• KMID: 2522440
• DOI: http://doi.org/10.4132/jptm.2021.08.04

Abstract

Background
Glioblastoma is the most aggressive primary malignant brain tumor in adults and is characterized by poor prognosis. Immune evasion occurs via programmed death-ligand 1 (PD-L1)/programmed death receptor 1 (PD-1) interaction. Some malignant tumors have responded to PD-L1/PD-1 blockade treatment strategies, and PD-L1 has been described as a potential predictive biomarker. This study discussed the expression of PD-L1 and CD8 in glioblastomas.
Methods
Thirty cases of glioblastoma were stained immunohistochemically for PD-L1 and CD8, where PD-L1 expression in glioblastoma tumor tissue above 1% is considered positive and CD-8 is expressed in tumor infiltrating lymphocytes. The expression of each marker was correlated with clinicopathologic parameters. Survival analysis was conducted to correlate progression-free survival (PFS) and overall survival (OS) with PD-L1 and CD8 expression.
Results
Diffuse/fibrillary PD-L1 was expressed in all cases (mean expression, 57.6%), whereas membranous PD-L1 was expressed in six of 30 cases. CD8-positive tumor-infiltrating lymphocytes (CD8⁺ TILs) had a median expression of 10%. PD-L1 and CD8 were positively correlated (p = .001). High PD-L1 expression was associated with worse PFS and OS (p = .026 and p = .001, respectively). Correlation of CD8⁺ TILs percentage with age, sex, tumor site, laterality, and outcomes were statistically insignificant. Multivariate analysis revealed that PD-L1 was the only independent factor that affected prognosis.
Conclusions
PD-L1 expression in patients with glioblastoma is robust; higher PD-L1 expression is associated with lower CD8+ TIL expression and worse prognosis.

Keyword

Glioblastoma; Programmed death ligand 1; Tumor-infiltrating lymphocytes; CD8; Survival analysis

Figure

• 

  Fig. 1 Glioblastoma sections stained for CD8 and programmed death-ligand 1 (PD-L1). CD8+ tumor-infiltrating lymphocytes (TIL) membranous/cytoplasmic staining in the high infiltration group (A) and low infiltration group (B). CD8+ TIL membranous/cytoplasmic staining showing a perivascular distribution (C) and an intra-tumoral distribution (D). PD-L1+ tumor cells showing a diffuse/fibrillary pattern (E) and diffuse/fibrillary and membranous patterns (F).

• 

  Fig. 2 Kaplan-Meier curves showing survival functions. (A) Percentage of CD8+ tumor-infiltrating lymphocytes (TILs) in relation to progression-free survival (PFS). (B) Percentage of CD8+ TILs in relation to overall survival (OS). (C) Programmed death-ligand 1 (PD-L1) expression in relation to PFS. (D) PD-L1 expression in relation to OS.

Reference

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