الفهرس 
Breast CarcinomaOnly 14 pages are availabe for public view
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Abstract
PD-L1 gene is located on chromosome 9p24.1 and encodes a 33 kDa protein. it has an extracellular immunoglobulin V-like and C-like domains and a hydrophobic transmembrane region, followed by a 30-amino acid cytoplasmic tail. PD-L1 gene has a long 3′-UTR region and multiple acting elements, which are important in post-transcriptional regulation.
The binding of PD-L1 ligand to its receptor programmed cell death-1 (PD-1) prevents autoimmunity by reducing T-cell expansion and decreasing cytokine production. However, in case of tumor cells, the same immunosuppressive effect permits the tumor to evade immune destruction. Some types of breast cancer (e.g., TNBC) are immunogenic and may overexpress PD-L1. These types have been shown to be more sensitive to immune therapy drugs such as immune checkpoint inhibitors.
This study aimed to detect the expression of PD-L1 expression in both tumor cells and inflammatory cells in patients diagnosed with non-metastatic breast carcinoma and detect its relationship with disease features and patient’s outcome.
To elucidate our results, this was a retrospective study included breast carcinoma patients, who presented to Oncology Department in Menoufia University Hospitals.
All patients were selected according to the inclusion and exclusion criteria:
Inclusion criteria: Patients diagnosed with primary breast carcinoma and paraffin blocks with enough tissue to detect the PDL-1. Exclusion criteria: Patients with missed data and paraffin blocks that contain not enough tissue to detect the PDL-1.
All participants included in our study were subjected to the following: Written or informed consent. We were collected data for each individual patient, Through history and clinical examination e.g., Demographics, tumor characteristics (size, regional node status, histological characteristics, and grade). Type and timing of operation, margin status, lymph node status, lymph vascular and perineural invasion, capsular infiltration and presence or absence of in situ component and pathological examination.
Results can be summarized as follow:
PDL-1 expression was positive in 33 patients (55%) in the intra-tumoral lymphocytes. Out of the only 3 patients (9.1 % of positive cases) had strong expression. The Mean ± SD of the H score for the positive cases was (8.27 ± 8.24).
PDL1 intra-epithelial expression was positive in 27 patients (45%) of the studied patients. Among those patients only 6 patients (22%) experienced strong expression.
There was no significant relation between PDL1 expression on tumor infiltrating lymphocytes and patients’ and disease features.
There were significant relations between positive PDL1 expression and triple negative, ER negative, PR negative.
There was significant relation between PDL1 intensity in intra-tumoral lymphocytes and tumor stage (P value: 0.006) higher intensity was associated with stage III.
There were no significant relations between PDL1 H-score in intra-tumoral lymphocytes and different patients and disease parameters.
Univariate analysis for factors affectingdisease free survival were age, tumor size, Her2neu expression, and PDL1 expression on malignant epithelial cells and PDL1 H-score in malignant epithelial cells.
Multivariate analysis revealed that, increased tumor size, Her2neu positive disease, and negative PDL1 expression on malignant epithelial cells were independent risk factors for disease progression.