1. Division of Digestive Surgery, Xijing Hospital of Digestive Diseases, Fourth Military Medical University,127 West Changle Road, 710032, Xi'an, Shaanxi, China
2. Department of General Surgery, No. 91 Central Hospital of PLA, 454000, Jiaozuo, Henan, China.
3. Department of General Surgery, No. 534 Hospital of PLA, 471000, Luoyang, Henan, China.
Background: Evidence about the association between programmed cell death ligand 1 (PD-L1) expression and prognosis of esophageal squamous cell carcinoma (ESCC) were limited and controversial. Thus, the present study aims to investigate the prognostic value of tumor immune microenvironment (TIM) based on PD-L1 expression and CD8+ T cell infiltration in ESCC tissues.
Methods: From September 2008 to March 2010, a total of 146 ESCC patients received radical esophagectomy were retrospectively analyzed in our present study. PD-L1 expression and CD8+ T cell infiltration were evaluated through immunohistochemistry. The clinicopathological characteristics and survival were analyzed.
Results: There were 111 male and 35 female. The median age was 59.1 years (37-78 years). The positive rate of PD-L1 expression was 61.7%. The rate of high CD8+ T cell infiltration was 33%. No significant differences were found between clinicopathological features and PD-L1 expression or CD8+ T cell infiltration. PD-L1 expression was significantly associated with poor overall survival (P=0.010). However, CD8+ T cell infiltration was not a prognostic risk factor. Type of TIM was significantly associated with the prognosis of ESCC patients (P=0.021).
Conclusions: PD-L1 expression was an independent risk factor for the prognosis of ESCC patients. Immunotherapy may achieve promising outcomes in ESCC patients with type I TIM.
Keywords: esophageal squamous cell carcinoma, programmed cell death ligand 1, tumor immune microenvironment, prognosis