High programmed cell death 1 ligand–1 expression: association with CD8+ T-cell infiltration and poor prognosis in human medulloblastoma

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OBJECTIVE

Medulloblastoma is a type of malignant tumor arising in the cerebellum. The clinical importance of programmed cell death 1 ligand–1 (PD-L1) expression in medulloblastoma remains unknown. The aim of the present study was to examine the expression of PD-L1 and tumor-infiltrating T cells, and to evaluate their relationships to the prognosis of patients with medulloblastoma.

METHODS

The authors immunohistochemically analyzed PD-L1 expression and CD3+ and CD8+ lymphocyte infiltrations in tumor specimens from 16 patients with medulloblastoma.

RESULTS

High expression of PD-L1 was observed in 9 (56.3%) of 16 samples studied. High expression of PD-L1 was associated with low infiltrations of CD3+ or CD8+ lymphocytes. Patients with high expression of PD-L1 had shorter progression-free survival and overall survival times than those with low expression (p = 0.076 and p = 0.099, respectively). In addition, patients with high expression of PD-L1 and with low infiltration of CD8+ lymphocytes had a significantly worse outcome, with a 5-year survival rate of 15%, as compared with the other patients, who had a 5-year survival rate of nearly 90% (p = 0.0048 for progression-free survival and p = 0.010 for overall survival).

CONCLUSIONS

These findings indicate that PD-L1 expression was associated with a reduced infiltration of CD8+ T cells and poor prognosis in human medulloblastoma.

ABBREVIATIONS OS = overall survival; PD-L1 = programmed cell death 1 ligand–1; PFS = progression-free survival.

Article Information

Correspondence Yoshiki Arakawa, Department of Neurosurgery, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan. email: yarakawa@kuhp.kyoto-u.ac.jp.

INCLUDE WHEN CITING Published online May 5, 2017; DOI: 10.3171/2016.11.JNS16991.

Disclosures The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.

© AANS, except where prohibited by US copyright law.

Headings

Figures

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    Photomicrographs of sections used for immunohistochemical analysis and evaluation of PD-L1, CD3, and CD8 in human medulloblastoma specimens. Expression of PD-L1 and infiltration of CD3+ and CD8+ lymphocytes were analyzed by immunohistochemical studies in tumor specimens obtained in patients with medulloblastoma. Representative cases of high and low expression and/or infiltration are shown. Trypan blue, hematoxylin counterstain; original magnification ×400.

  • View in gallery

    Kaplan-Meier curves showing survival of patients with medulloblastoma stratified by PD-L1, CD3, and CD8 staining. The OS and PFS of patients with medulloblastoma was shown according to expression of PD-L1 (A and B) and the infiltration of CD8+ (C and D) and CD3+ lymphocytes (E and F).

  • View in gallery

    Kaplan-Meier curves showing that high PD-L1 expression and low CD8+ lymphocyte infiltration (PDL1[H]+CD8[L]) was associated with worse survival in patients with medulloblastoma. The OS (left) and PFS (right) of patients with medulloblastoma was compared between tumors with high PD-L1 expression and low CD8+ lymphocyte infiltration and the other types of tumors.

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