Abstract
BackgroundThe effect of schistosomiasis on CD8+ T cells and then on PD-L1 expression was unknown, and the utility of CD8+ TILs as a biomarker for schistosomal-associated colorectal cancer (SCRC) rarely has been reported.MethodsThree hundred thirty-eight patients with colorectal cancer (CRC) were enrolled. Immunohistochemical analysis was conducted to evaluate the expression of PD-L1 and the infiltration of CD8+ T cells.ResultsIn the total cohort, the results showed that CD8+ TIL density was positively correlated with tumoral (p = 0.0001) and stromal PD-L1 expression (p = 0.0102). But there were no correlation between schistosomiasis and CD8+ TILs and PD-L1. Furthermore, CD8+ TIL density (p = 0.010), schistosomiasis (p = 0.042) were independent predictive factors for overall survival (OS). Stromal PD-L1 (sPD-L1) was correlated with OS (p = 0.046), but it was not an independent predictor. In patients without schistosomiasis, CD8 + T cells (p = 0.002) and sPD-L1 (p = 0.005) were associated with better OS. In patients with schistosomiasis, CD8 + T cells were independent prognosis factor (p = 0.045).ConclusionsThe study showed that CD8+ TILs was an independent predictive factor for OS in CRC and SCRC patients. The expression of PD-L1 was positively associated with CD8 + TILs density. There were no correlation between schistosomiasis and CD8 + TILs and PD-L1. Stromal PD-L1 but not tPD-L1 was significantly associated with OS, whereas it was not an independent prognostic factor.
Highlights
Colorectal cancer is one of the most common malignant diseases worldwide
It has been reported that Programmed cell death-ligand 1 (PD-L1) on either tumor cells or host immune cells contributes to tumor escape, and the relative contributions of PD-L1 on these cells seem to be context-dependent [5]
Higher PD-L1 expression on both tumor cells and within the immune stroma was associated with better overall survival (OS) in colorectal cancer (CRC) patients, but only the Stromal PD-L1 (sPD-L1) reached statistical significance (p = 0.0023, Fig. 3A for sPD-L1; p = 0.3693, Fig. 3B for Expression of PD-L1 within tumor cells (tPD-L1))
Summary
Colorectal cancer is one of the most common malignant diseases worldwide. a variety of anticancer drugs have been developed, the death rates of CRC have not been obviously decreased [1, 2]. Recent study showed that tumoral PD-L1 is a favorable prognostic factor in early stage of non-small cell carcinoma [6]. It was reported that there were differences in outcome in triple-negative breast cancer depending on the expression of PD-L1 in the tumoral cell membrane, cytoplasm, and stromal cellular compartments [7]. Yaqi Li et al reported that tumoral PD-L1 correlated with better prognosis of CRC patients [8]. Whereas some studies found that PD-L1 was associated with deleterious effect on survival [9, 10], these studied did not distinguish PD-L1 expression in tumoral or stromal cells. The effect of schistosomiasis on CD8+ T cells and on PD-L1 expression was unknown, and the utility of CD8+ TILs as a biomarker for schistosomal-associated colorectal cancer (SCRC) rarely has been reported
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