PD-1 and PD-L1 expression in 132 recurrent nasopharyngeal carcinoma: the correlation with anemia and outcomes

Abstract

// Yajuan Zhou 1, 2, * , Jingjing Miao 3, * , Haijun Wu 3 , Hao Tang 4 , Jing Kuang 4 , Xiaoyi Zhou 2 , Yi Peng 2 , Desheng Hu 2 , Dingbo Shi 5 , Wuguo Deng 5 , Xinyue Cao 6 , Chong Zhao 1, 3 and Conghua Xie 1 1 Hubei Key Laboratory of Tumor Biological Behaviors, Department of Radiation and Medical Oncology, Zhongnan Hospital of Wuhan University, Wuhan, China 2 Department of Radiation Oncology, Hubei Cancer Hospital, Wuhan, China 3 Department of Nasopharynx, Collaborative Innovation Center for Cancer Medical, State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Center, Guangzhou, China 4 Department of Pathology, Hubei Cancer Hospital, Wuhan, China 5 Collaborative Innovation Center for Cancer Medical, State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Center, Guangzhou, China 6 Department of Biological Repositories, Zhongnan Hospital of Wuhan University, Wuhan, China * These authors contributed equally to this work Correspondence to: Chong Zhao, email: [e-mail] Conghua Xie, email: [e-mail] Keywords: PD-L1, PD-1, HIF-1α, nasopharyngeal carcinoma, recurrent Received: January 04, 2017      Accepted: March 31, 2017      Published: April 19, 2017 ABSTRACT The expression of Programmed death-1 (PD-1) / programmed death-ligand 1 (PD-L1) has been reported to be reliable prognostic factors in various malignances including primary nasopharyngeal carcinoma (NPC). However, the exact role of PD-1/PD-L1 in recurrent NPC remains unclear. In this study, we aimed to investigate the relationship between the expression of PD-1 / PD-L1 and the clinical-pathology as well the outcomes of recurrent NPC patients (n = 132). The expression of PD-1 and PD-L1 was measured by immunohistochemistry staining. The relationship between PD-1 / PD-L1 and factors involved in clinic-pathology and outcomes of patients with NPC was assessed by correlation analysis. To further explore the association between PD-L1 and anemia, immunofluorescence analysi s was performed to investigate the correlation of PD-L1 with hypoxia inducible factor-1α (HIF-1α). We observed that advanced rT classification and anemia status before salvage treatment was associated with high level of PD-L1 in recurrent NPC patients, and PD-L1 and was co-located with HIF-1α in recurrent tumors by immunofluorescence analysis. Moreover, our result suggested that PD-L1 might be a negative indicator for recurrent NPC patients as well as age, rT classification, anemia and tumor necrosis at diagnose of recurrence. Taken together, our results revealed that PD-L1 might be a potential prognostic biomarker for recurrent NPC patients, and advanced re-stage, anemia might represent as candidate biomarkers for evaluating patients’ response to anti-PD-1 / PD-L1-treatment. However, further studies are needed to clarify the underlying mechanism of hypoxia in immunosuppression process induced by PD-1 / PD-L1 axis.