Abstract
Introduction and Aim: Aberrant over expression of PD L1 by tumours and tumour infiltrating lymphocytes provide an immune shield to the tumours. The present study aims to evaluate the effect of over expression of PD L1 in tumour cells and tumour infiltrating lymphocytes on various clinicopathological aspects of gastric carcinoma including the follow up and survival analysis. Materials and Methods: Paraffin blocks were retrieved from 100 cases of primary gastric carcinoma who underwent curative resection. Immunostaining was done using a qualitative immunohistochemical assay from Ventana Roche with rabbit monoclonal anti PD-L1 clone SP142 intended for use in the assessment of the PD-L1 protein in formalin -fixed, paraffin -embedded (FFPE) tissue. Results: Out of 100 cases 65 were males and 35 were females. PD-L1 expression is observed in tumour cells in 17 cases and tumour infiltrating immune cells in 44 cases. Statistically significant correlation of expression of PD-L1 was observed with the clinicopathological characteristics like, larger tumour size (p value 0.03), lymphovascular invasion (p value 0.01), lymph node metastasis (p value 0.01) and higher tumour stage (p value 0.02). Two years follow up did not show any statistically significant correlation between PD-L1 expression in tumour cells and tumour infiltrating immune cells and survival (p value 0.27). Conclusion: Present study shows a substantial expression of PD-L1 in patients with gastric carcinoma. Hence PD-L1 immunohistochemistry can be potentially helpful in screening candidates for anti PD-L1 therapy.
Highlights
Introduction and AimAberrant over expression of PD L1 by tumours and tumour infiltrating lymphocytes provide an immune shield to the tumours
Present study shows a substantial expression of Programmed death-ligand 1 (PD-L1) in patients with gastric carcinoma
PDL1 immunohistochemistry can be potentially helpful in screening candidates for anti PD-L1 therapy
Summary
Introduction and AimAberrant over expression of PD L1 by tumours and tumour infiltrating lymphocytes provide an immune shield to the tumours. Despite advances in diagnosis and treatment the five year survival is only 20% Further it accounts for nearly 15% of cancer related deaths across the globe. The presenting symptoms of gastric cancer are vague and usually present with the triad of anaemia, weight loss and loss of appetite which leads to delayed diagnosis and presentation in advanced stage of the disease [3]. Due to this late presentation the only option available will be chemotherapy in most cases. Search for alternate modes of treatment resulted in development of treatment protocols targeting biological markers like Human Epidermal growth factor receptor (HER2) and Mesenchymal epithelial transition factor (c-MET), and immunological strategies i.e. inhibition of immune check points like Programmed death-ligand 1 (PD-L1)
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