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Expression of PD-L1 in keratoacanthoma and different stages of progression in cutaneous squamous cell carcinoma

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Cancer Immunology, Immunotherapy Aims and scope Submit manuscript

Abstract

Background

Programmed cell death 1 (PD-1) and its ligands (PD-L1) play a major role in the immune responses of a variety of cancers.

Objectives

To investigate the expression of PD-L1 in different progression forms of cutaneous squamous cell carcinoma (cSCC) and keratoacanthoma (KA).

Methods

We performed immunohistochemical staining of 21 KA, 26 actinic keratoses (AK), 20 Bowen´s diseases (BD), and 26 high-risk cSCC. The staining patterns were assessed using the tumour proportion score and staining intensity evaluation. Immunohistology scores were statistically analysed.

Results

PD-L1 expression of tumour cells as well as tumour-infiltrating cells (TILs) was significantly higher in KA and cSCC when compared to AK and BD (P = 0.00028 and P = 0.00033, respectively). We observed a very strong positive correlation between the PD-L1 protein expression of tumour cells of KA and the PD-L1 protein expression of TILs (r = 0.97; P < 0.0001). A similar correlation was also found for cSCC (r = 0.86; P < 0.0001). The percentage of PD-L1 + tumours was 33.3% for KA and 26.9% for cSCC. Similarly, the percentage of PD-L1 + TILs in KA and cSCC was 33.3 and 34.6%, respectively.

Conclusions

PD-L1 is differently expressed in cSCC and closely related non-melanoma skin cancer. cSCC exhibit PD-L1 expression in a fourth of cases, indicating that PD1/PD-L1 inhibitors might be beneficial in a proportion of patients with an inoperable or metastatic cSCC. Unlike AK and BD, TILs and tumour cells of KA and cSCC present very similar PD-L1 expression profiles indicating a common immune escape mechanism.

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Abbreviations

AK:

Actinic keratosis

BD:

Bowen´s disease

cSCC:

Cutaneous squamous cell carcinoma

KA:

Keratoacanthoma

NMSC:

Non-melanoma skin cancer

TPS:

Tumour proportion score

UICC:

Union Internationale Contre le Cancer

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Acknowledgements

This work is part of the doctoral thesis of Martha Gnielka.

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Authors and Affiliations

  1. Skin Cancer Center of the Department of Dermatology, St. Josef Hospital, Ruhr-University Bochum, Gudrunstr. 56, 44791, Bochum, Germany

    Thilo Gambichler, Martha Gnielka, Ines Rüddel, Eggert Stockfleth, Markus Stücker & Lutz Schmitz

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  1. Thilo Gambichler
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  2. Martha Gnielka
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Correspondence to Lutz Schmitz.

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Gambichler, T., Gnielka, M., Rüddel, I. et al. Expression of PD-L1 in keratoacanthoma and different stages of progression in cutaneous squamous cell carcinoma. Cancer Immunol Immunother 66, 1199–1204 (2017). https://doi.org/10.1007/s00262-017-2015-x

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  • DOI: https://doi.org/10.1007/s00262-017-2015-x

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