J Cancer 2019; 10(13):3070-3078. doi:10.7150/jca.30573

Research Paper

Clinicopathological and prognostic significance of programmed death ligand 1 expression in Korean melanoma patients

Sumi Yun1, Yujun Park2, Seyoung Moon2, Soomin Ahn2, Kyoungyul Lee3, Hyo Jin Park4, Hye Seung Lee2, Gheeyoung Choe2, Kyu Sang Lee2✉

1. Department of Diagnostic Pathology, Samkwang Medical Laboratories, Seoul, Republic of Korea
2. Department of Pathology, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea
3. Department of Pathology, Kangwon National University Hospital, Chuncheon-Si, Kangwon-Do, Republic of Korea
4. Department of Pathology, Sheikh Khalifa Specialty Hospital, Ras al Khaimah, United Arab Emirates

This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY-NC) license (https://creativecommons.org/licenses/by-nc/4.0/). See http://ivyspring.com/terms for full terms and conditions.
Citation:
Yun S, Park Y, Moon S, Ahn S, Lee K, Park HJ, Lee HS, Choe G, Lee KS. Clinicopathological and prognostic significance of programmed death ligand 1 expression in Korean melanoma patients. J Cancer 2019; 10(13):3070-3078. doi:10.7150/jca.30573. Available from http://www.jcancer.org/v10p3070.htm

File import instruction

Abstract

Programmed death ligand 1 (PD-L1) expression provides significant value to predict prognosis and response following immunotherapy in several types of cancers. However, its clinicopathological and prognostic significance in melanoma remains unclear. PD-L1 and the number of tumor infiltrating lymphocytes (TILs) were investigated in 63 Korean patients with melanoma based on the melanoma scoring system. We also compared the results using the PD-L1 antibodies—22C3 and E1L3N clones. In addition, BRAF gene mutation was detected using anti-BRAF antibody and real-time polymerase chain reaction. Overall, 29 (46.0%), 16 (25.4%), and 18 (28.6%) patients exhibited the acral lentiginous type, nodular type, and other histological subtypes of melanoma, respectively. PD-L1 expression was detected in 37 (58.7%) cases and was closely associated with a CD8+TILhigh phenotype (P < 0.001). Combined survival analysis depending on PD-L1 and CD8+TILs status showed that the PD-L1-/CD8+TILhigh group demonstrated the best survival outcome, whereas patients with PD-L1+/CD8+ TILlow showed the worst prognosis (P = 0.039). However, PD-L1+/CD8+ TILlow was not an independent prognostic factor. The 22C3 and E1L3N clones showed a high concordance rate (kappa value, 0.799). BRAF mutation status was not correlated with PD-L1 expression. We suggest that evaluation of the combined status of PD-L1 and TIL might be useful to predict the survival of patients with melanoma.

Keywords: melanoma, prognosis, programmed death ligand 1, tumor infiltrating lymphocytes, 22C3