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. 2023 Jul 15;11(7):2003.
doi: 10.3390/biomedicines11072003.

Prognostic Significance of PD-L1 Expression in Gastric Cancer Patients with Peritoneal Metastasis

Xiao-Jiang Chen  1 , Cheng-Zhi Wei  1 , Jun Lin  1 , Ruo-Peng Zhang  1 , Guo-Ming Chen  1 , Yuan-Fang Li  1 , Run-Cong Nie  1 , Yong-Ming Chen  1
Affiliations

Prognostic Significance of PD-L1 Expression in Gastric Cancer Patients with Peritoneal Metastasis

Xiao-Jiang Chen et al. Biomedicines. .

Abstract

Background: Recently, many studies have explored the relationship between the expression of programmed death ligand 1 (PD-L1) and prognosis in gastric cancer, but there is still controversy. Additionally, few studies have specifically investigated the expression of PD-L1 in patients with peritoneal metastasis.

Methods: Immunohistochemistry was used to analyze the expression of PD-L1 in gastric cancer patients with peritoneal metastasis. The combined positive score (CPS) was calculated to evaluate the expression of PD-L1, and the clinicopathological data were analyzed to explore prognostic significance.

Results: In total, 147 gastric cancer patients with peritoneal metastasis were enrolled. The negative PD-L1 expression was defined as a CPS < 1, and high PD-L1 expression was defined as a CPS ≥ 10. PD-L1 expression with CPS ≥ 1 and CPS-negative was detected in 67 (45.58%) and 80 (54.42%) patients, respectively. High PD-L1 expression at PD-L1 CPS ≥ 10 was detected in 21(14.29%) patients. The median overall survival (OS) was 18.53 months in the CPS < 10 group and 27.00 months in the CPS ≥ 10 group; the OS difference between the two groups was significant (p = 0.015). Multivariate analysis demonstrated that a poor Eastern Cooperative Oncology Group performance score (ECOG PS) (p = 0.002) and severe peritoneal metastasis (p = 0.033) were significantly associated with poor survival, while palliative chemotherapy (p = 0.002) and high PD-L1 expression (p = 0.008) were independent and significantly favorable prognostic factors.

Conclusions: Our study demonstrated that PD-L1 expression was widely presented in gastric cancer patients with peritoneal metastasis, while a CPS no less than 10 predicted better prognosis.

Keywords: PD-L1; gastric cancer; peritoneal metastasis; prognosis.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Immunohistochemistry analysis of the expression of PD-L1 in gastric cancer patients with peritoneal metastasis. (A) Representative of tissue sections of patients with high PD-L1 expression. (B) Representative of tissue sections of patients with low PD-L1 expression. The scale bar represents 100 μm.
Figure 2
Figure 2
Comparison of overall survival (OS) and progression-free survival (PFS) for the ex-pression of PD-L1 in the 147 gastric cancer patients with peritoneal metastasis. The dashed lines indicate the median OS in (A and C) and the median PFS in (B and D). (A) The OS of the positive PD-L1 expression group. (B) The PFS of the positive PD-L1 expression group. (C) The OS of the high PD-L1 expression group. (D) The PFS of the high PD-L1 expression group.
Figure 3
Figure 3
Comparison of overall survival (OS) for the ECOG PS, degree of peritoneal metastasis, and chemotherapy in the 147 gastric cancer patients with peritoneal metastasis. The dashed lines indicate the median OS. (A) For ECOG PS. (B) For degree of peritoneal metastasis. (C) For chemotherapy.
See this image and copyright information in PMC

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