PD-1/PD-L1 轴在 HER2+ 乳腺导管原位癌（DCIS）中的作用。

The PD-1/PD-L1 Axis in HER2+ Ductal Carcinoma In Situ (DCIS) of the Breast.

机构信息

Breast Pathology Section, Department of Pathology, Northwestern University Feinberg School of Medicine, Robert H. Lurie Comprehensive Cancer Center, Chicago, IL.

出版信息

Am J Clin Pathol. 2019 Jul 5;152(2):169-176. doi: 10.1093/ajcp/aqz020.

DOI:10.1093/ajcp/aqz020

PMID:30984969

Abstract

OBJECTIVES

The aims were to evaluate the programmed death 1 (PD-1)/programmed death ligand 1 (PD-L1) axis in ductal carcinoma in situ (DCIS) of the breast.

METHODS

We reviewed 85 pure DCIS cases treated with surgical excision at our institution, including 51 luminal A (estrogen receptor [ER] positive/human epidermal growth factor 2 [HER2] negative), 15 luminal B (ER+/HER2+), 13 HER2 (ER-/HER2+), and six basal-like (ER-/HER2-/CK5/6+). The extent and intensity of PD-1 and PD-L1 immunohistochemical staining in the tumor-infiltrating lymphocytes (TILs) and in the tumor cells were recorded.

RESULTS

Our study found that moderate/severe inflammation around DCIS correlated with HER2 expression (20/28 HER2+ cases [71%] vs 21/57 HER2- cases [37%], P = .005). Of interest, over half of the TILs around the HER2 subtype expressed PD-L1 (7/13, 54%). In addition, about one-third of TILs around the HER2 subtype expressed PD-1 (4/13, 31%).

CONCLUSIONS

These findings suggest that immune-based therapeutic strategies may be used as a potential therapy in DCIS cases with PD-L1 overexpression, especially those of the HER2 molecular subtype.

摘要

目的

评估乳腺导管原位癌（DCIS）中程序性死亡受体 1（PD-1）/程序性死亡配体 1（PD-L1）轴。

方法

我们回顾了在我院接受手术切除治疗的 85 例纯 DCIS 病例，包括 51 例 luminal A（雌激素受体 [ER]阳性/人表皮生长因子 2 [HER2]阴性）、15 例 luminal B（ER+/HER2+）、13 例 HER2（ER-/HER2+）和 6 例基底样（ER-/HER2-/CK5/6+）。记录肿瘤浸润淋巴细胞（TILs）和肿瘤细胞中 PD-1 和 PD-L1 免疫组织化学染色的程度和强度。

结果

我们的研究发现，DCIS 周围中度/重度炎症与 HER2 表达相关（28 例 HER2+病例中有 20 例 [71%]，57 例 HER2-病例中有 21 例 [37%]，P =.005）。有趣的是，HER2 亚型周围的 TIL 中超过一半表达 PD-L1（13 例中有 7 例 [54%]）。此外，HER2 亚型周围的 TIL 中约有三分之一表达 PD-1（13 例中有 4 例 [31%]）。