Expression of PD-1 in Tumor Cells is Associated with Shorter Survival  in Non-metastatic Intestinal-type Gastric Adenocarcinoma

Niloofar Namvar; Mehdi Montazer; Simin Ahmadvand; Bahare Sadeghian; Abbas Ghaderi

doi:10.18502/ijaai.v21i6.11519

Niloofar Namvar Department of Immunology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
Mehdi Montazer Department of Pathology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Simin Ahmadvand Shiraz Institute for Cancer Research, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
Bahare Sadeghian Department of Pathology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Abbas Ghaderi Department of Immunology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran

DOI: https://doi.org/10.18502/ijaai.v21i6.11519

Keywords: Immunohistochemistry; CD45RO antigens; DNA mismatch repair; PD-L1; PD-1; Stomach neoplasms

Abstract

There is an urgent need to discover novel prognostic biomarkers and treatment strategies for gastric cancer (GC) patients. Several immune-related markers have been proposed as prognostic tools and immunotherapeutic targets to manage diseases. In this regard, we evaluated the expression pattern and prognostic significance of programmed death-1 (PD-1), programmed death-ligand 1 (PD-L1), CD45RO⁺ tumor-infiltrating lymphocytes (TILs), and DNA mismatch repair (MMR) proteins (MLH1, MSH2, PMS2, and MSH6) in non-metastatic intestinal-type gastric adenocarcinoma.

Samples and data from 70 GC patients were collected. Immunohistochemistry staining was used to detect the markers. We then evaluated the prognosis significance of each marker and their intercorrelation.

Cytoplasmic PD-1 expressed by tumor cells was significantly associated with poorer survival. However, multivariate analysis indicated stronger prognostic values for TNM stage, tumor location, and extracellular mucin. A significant positive association was found between CD45RO^highTILs and PD-1 expression on tumor-infiltrating cells (TICs). All GC patients with deficient MMR (d‑MMR) had a high number of CD45RO⁺ TILs and PD-1⁺ TICs.

Despite the association of PD‑1 overexpression in TCs with shorter overall survival, histopathological factors, including tumor location, TNM stage, and extracellular mucin, remain the most decisive prognostic factors in non-metastatic intestinal-type gastric adenocarcinoma. Additionally, our data support a prognostic role for d-MMR and CD45RO, but not PD-1 and PD-L1 expression on TICs.