Abstract

CD70 – a ligand protein of CD27 on lymphocytes – is expressed in a large spectrum of malignancies. It is an attractive target for antibody-based therapy and several clinical trials are currently being conducted. However, there is no evidence regarding the expression of CD70 and its relationship with expression of programmed death ligand-1 (PD-L1) and CD27+ tumor-infiltrating lymphocytes (TIL) in formalin-fixed paraffin-embedded (FFPE) tissues of thymic tumors. FFPE tissues of thymic squamous cell carcinoma (TSCC) (operative specimens, n = 31; biopsy specimens, n = 11), thymoma (n = 60), thymic carcinoid (n = 3), and lung squamous cell carcinoma (LSCC) (n = 30) were analyzed immunohistochemically. Immunoreactivity for CD70 was semi-quantitatively scored according to the proportion of positive tumor cells. Moreover, the densities of CD27-positive intratumoral TIL (iTIL) and stromal TIL of TSCC were assessed and survival was compared. Most TSCC cases (87%; 27/31) were CD70-positive. In contrast, all thymoma and thymic carcinoid cases were CD70-negative. In LSCC cases, CD70-positivity was significantly lower than TSCC cases (20%; 6/30). Biopsy and resected specimens obtained from the same patients demonstrated a consistent staining pattern (6/6 patients). The proportion of CD70-positive TSCC was comparable with those of CD5 (87%) and CD117 (90%). Correlation between CD70 and PD-L1 expression score was observed. There was no significant difference in survival between the CD70-high and CD70-low expression groups. Meanwhile, patients with CD27-positive iTIL-high tumors exhibited better survival than those with iTIL-low tumors. This tendency was weaker in the CD70-high subset. CD70 immunohistochemistry is useful in diagnosing TSCC. CD70 may prevent anti-tumor immunity via CD27. Immunotherapy targeting the CD70–CD27 axis may be a promising option for the treatment of TSCC.

Highlights

  • CD70 belongs to the tumor necrosis factor family of proteins and acts as a ligand of CD27

  • Thymic squamous cell carcinoma (TSCC), which accounts for the majority of thymic carcinoma cases, has some histological mimickers, such as type B3 thymoma and lung squamous cell carcinoma (LSCC)

  • These results indicate that CD70 can be utilized as a specific marker discriminating TSCC from thymoma

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Summary

Introduction

CD70 belongs to the tumor necrosis factor family of proteins and acts as a ligand of CD27. Thymic epithelium and activated Tcells and B-cells are known to express CD70 [1], which promotes differentiation to effector or memory T-cells by expressing CD27 on lymphocytes [2]. Thymic carcinoma is a rare disease, accounting for 14% of thymic epithelial tumors according to the International Thymic Malignancy Interest Group database [7]. Thymic squamous cell carcinoma (TSCC), which accounts for the majority of thymic carcinoma cases, has some histological mimickers, such as type B3 thymoma and lung squamous cell carcinoma (LSCC). Immunohistochemical (IHC) analysis of CD5, CD117 (KIT), GLUT-1, and MUC1 is useful in differentiating TSCC from type B3 thymoma [8,9,10,11,12,13,14,15,16,17,18,19]. CD5 and CD117 are helpful in distinguishing TSCC from LSCC [13, 14, 18]

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