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Ubukata Y, Ogata K, Sohda M, Yokobori T, Shimoda Y, Handa T, Nakazawa N, Kimura A, Kogure N, Sano A, Sakai M, Ogawa H, Kuwano H, Shirabe K, Oyama T, Saeki H. Role of PD-L1 Expression during the Progression of Submucosal Gastric Cancer. Oncology 2020; 99:15-22. [PMID: 33113541 DOI: 10.1159/000509033] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 05/28/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Programmed death-ligand 1 (PD-L1) expression is a prognostic marker for gastric cancer that correlates with tumor diameter and depth of penetration. But the role of PD-L1 and mechanism(s) employed in the initial phase of invasion in early gastric cancer is yet to be understood. OBJECTIVE This study aims to elucidate the role of PD-L1 during the progression of gastric cancer, specifically invading the submucosa beyond the lamina muscularis mucosa. METHODS Using 107 patients with pathological submucosal gastric cancer, we determined the expression of PD-L1 based on the staining of the cell membrane or cytoplasm of tumor cells in the central and invasive front of the tumor. Samples were categorized into 3 groups based on the intensity of PD-L1 expression. CD8+ lymphocytes expressing PD-1 and CD163+ macrophages were used to determine the number of cell nuclei at the invasive front, similar to PD-L1. CMTM6 levels were determined and used to stratify samples into 3 groups. RESULTS PD-L1 expression was higher in the invasive front (26.2%) than in the central portion of the tumors (7.4%; p < 0.001). Moreover, lymphatic and vascular invasion were more frequently observed in samples with high levels of PD-L1 (lymphatic invasion: 60.7 vs. 35.4%, p = 0.0026, and vascular invasion: 39.3 vs. 16.5%, p = 0.0018). There was no correlation between PD-L1 expression and the levels of PD-1, CD8, CD163, and CMTM6. CONCLUSIONS PD-L1-expressing cancer cells at the invasive front of gastric cancer influence the initial stages of tumor invasion and lymphovascular permeation in early-stage gastric cancers. Immune checkpoint signaling may be the driving force in the invasive front during the invasion of the submucosa beyond the lamina muscularis mucosa.
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Affiliation(s)
- Yasunari Ubukata
- Department of General Surgery, Graduate School of Medical Sciences, Gunma University, Maebashi, Japan
| | - Kyoichi Ogata
- Department of General Surgery, Graduate School of Medical Sciences, Gunma University, Maebashi, Japan
| | - Makoto Sohda
- Department of General Surgery, Graduate School of Medical Sciences, Gunma University, Maebashi, Japan,
| | - Takehiko Yokobori
- Department of General Surgery, Graduate School of Medical Sciences, Gunma University, Maebashi, Japan
| | - Yuki Shimoda
- Department of Pathology, Graduate School of Medical Sciences, Gunma University, Maebashi, Japan
| | - Tadashi Handa
- Department of Pathology, Graduate School of Medical Sciences, Gunma University, Maebashi, Japan
| | - Nobuhiro Nakazawa
- Department of General Surgery, Graduate School of Medical Sciences, Gunma University, Maebashi, Japan
| | - Akiharu Kimura
- Department of General Surgery, Graduate School of Medical Sciences, Gunma University, Maebashi, Japan
| | - Norimichi Kogure
- Department of General Surgery, Graduate School of Medical Sciences, Gunma University, Maebashi, Japan
| | - Akihiko Sano
- Department of General Surgery, Graduate School of Medical Sciences, Gunma University, Maebashi, Japan
| | - Makoto Sakai
- Department of General Surgery, Graduate School of Medical Sciences, Gunma University, Maebashi, Japan
| | - Hiroomi Ogawa
- Department of General Surgery, Graduate School of Medical Sciences, Gunma University, Maebashi, Japan
| | - Hiroyuki Kuwano
- Department of General Surgery, Graduate School of Medical Sciences, Gunma University, Maebashi, Japan
| | - Ken Shirabe
- Department of General Surgery, Graduate School of Medical Sciences, Gunma University, Maebashi, Japan
| | - Tetsunari Oyama
- Department of Pathology, Graduate School of Medical Sciences, Gunma University, Maebashi, Japan
| | - Hiroshi Saeki
- Department of General Surgery, Graduate School of Medical Sciences, Gunma University, Maebashi, Japan
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