Assessment of PDL-1 expression in Triple-negative breast cancer via immunohistochemistry
DOI:
https://doi.org/10.51985/Keywords:
Breast carcinoma, Lymphocytes, Triple-negative breast neoplasmsAbstract
Objective: To assess the frequency of PDL-1 positivity triple-negative breast carcinoma (TNBC) and correlate it with the clinicopathological parameters.
Study Design and Setting: Cross-sectional study conducted at Histopathology Department of Rehman Medical Institute, Peshawar.
Methodology: The study period was from September 2023 to October 2024. Biopsy specimen of 41 female patients diagnosed with TNBC were received in the Histopathology department. Specimens underwent eosin/hematoxylin staining and immunohistochemistry analysis. Demographic and histopathological parameters were recorded and analyzed using SPSS version 23.
Results: Mean age was 54.58(6.14) years, and the most common type of TNBC was invasive breast carcinoma of no special type in 23(56.1%). Out of 41 specimens, we observed that stage N2 and stage T3 were the most prevalent as observed in 18(43.9%) and 19(46.3%) specimens respectively. Frequency of PDL-1 positivity was observed in 16(39.02%) with a trend towards higher PDL-1 positivity observed in invasive ductal carcinoma of no special type and tumors exhibiting size of >20mm. Lymphovascular invasion was seen in 17 (41.46%) out of which 09 (56.3%) were PDL-1 positive. Tumor-infiltrating lymphocytes of the moderate category were significantly associated with PDL-1 positivity with a p-value of 0.024.
Conclusion: PDL-1 expression is observed in a substantial number (39.02%) of TNBC patients. Our research concludes an important association between PDL-1 expression and tumor-infiltrating lymphocytes in TNBC which enlightens new avenues for immunotherapy. This association may have profound implications in the future for prompt diagnosis and targeted treatment.
References
1. Giaquinto AN, Sung H, Miller KD, Kramer JL, Newman LA,
Minihan A, et al. Breast Cancer Statistics, 2022. CA A Cancer
J Clinicians. 2022 Nov;72(6):524–41.
2. Almansour NM. Triple-Negative Breast Cancer: A Brief
Review About Epidemiology, Risk Factors, Signaling
Pathways, Treatment and Role of Artificial Intelligence. Front
Mol Biosci. 2022 Jan 25;9:836417.
3. ER/PR-negative, HER2-negative (triple-negative) breast
cancer - UpToDate [Internet]. [cited 2025 Sep 6]. Available
from: https://www.uptodate.com/contents/er-pr-negative-her2-
negative-triple-negative-breast-cancer
4. Zagami P, Carey LA. Triple negative breast cancer: Pitfalls
and progress. npj Breast Cancer. 2022 Aug 20;8(1):95.
5. Derakhshan F, Reis-Filho JS. Pathogenesis of Triple-Negative
Breast Cancer. Annu Rev Pathol Mech Dis. 2022 Jan
24;17(1):181–204.
6. Bou Zerdan M, Ghorayeb T, Saliba F, Allam S, Bou Zerdan
M, Yaghi M, et al. Triple Negative Breast Cancer: Updates
on Classification and Treatment in 2021. Cancers. 2022 Feb
28;14(5):1253.
7. Cimino-Mathews A. Novel uses of immunohistochemistry
in breast pathology: interpretation and pitfalls. Modern
Pathology. 2021 Jan;34:62–77.
8. Kumar S, Bal A, Das A, Bhattacharyya S, Laroiya I, Khare
S, et al. Molecular Subtyping of Triple Negative Breast Cancer
by Surrogate Immunohistochemistry Markers. Applied
Immunohistochemistry & Molecular Morphology. 2021
Apr;29(4):251–7.
9. Nakhjavani M, Shigdar S. Future of PD-1/PD-L1 axis
modulation for the treatment of triple-negative breast cancer.
Pharmacological Research. 2022 Jan;175:106019.
10. Chen X, Feng L, Huang Y, Wu Y, Xie N. Mechanisms and
Strategies to Overcome PD-1/PD-L1 Blockade Resistance in
Triple-Negative Breast Cancer. Cancers. 2022 Dec
23;15(1):104.
11. Kornepati AVR, Vadlamudi RK, Curiel TJ. Programmed death
ligand 1 signals in cancer cells. Nat Rev Cancer. 2022
Mar;22(3):174–89
12. Howard FM, Olopade OI. Epidemiology of Triple-Negative
Breast Cancer: A Review. Cancer J. 2021 Jan;27(1):8–16.
13. Ghosh J, Chatterjee M, Ganguly S, Datta A, Biswas B,
Mukherjee G, et al. PDL1 expression and its correlation with
outcomes in non-metastatic triple-negative breast cancer
(TNBC). ecancer [Internet]. 2021 Apr 6 [cited 2025 Sep 6];15.
Available from: https://ecancer.org/en/journal/article/1217-
pdl1-expression-and-its-correlation-with-outcomes-in-nonmetastatic-triple-negative-breast-cancer-tnbc
14. Uðurluoðlu C, Yormaz S. Clinicopathological and prognostic
value of TIL and PD L1 in triple negative breast carcinomas.
Pathology - Research and Practice. 2023 Oct;250:154828.
15. Department of Pathology, Mardin State Hospital, Mardin,
Turkey, Dogukan R, Ucak R, Department of Pathology,
University of Health Sciences, Sisli Hamidiye Etfal Training
and Research Center, Istanbul, Turkey, Dogukan FM,
Department of Pathology, Mardin State Hospital, Mardin,
Turkey, et al. Correlation between the Expression of PD-L1
and Clinicopathological Parameters in Triple Negative Breast
Cancer Patients. Eur J Breast Health. 2019 Oct 1;15(4):235–41.
16. Al-Jussani GN, Dabbagh TZ, Al-Rimawi D, Sughayer MA.
Expression of PD-L1 using SP142 CDx in triple negative
breast cancer. Annals of Diagnostic Pathology. 2021
Apr;51:151703.
17. Pranoto AS, Haryasena H, Prihantono P, Rahman S,
Sampepajung D, Indra I, et al. The expression of programmed
death-ligand 1 and its association with histopathological grade,
stage of disease, and occurrence of metastasis in breast cancer.
Usman AN, editor. BD. 2021 Jun 25;40(s1):S71–6.
18. Chu J, Yeo MK, Lee SH, Lee MY, Chae SW, Kim HS, et al.
Clinicopathological and Prognostic Significance of
Programmed Death Ligand-1 SP142 Expression in 132 Patients
With Triple-negative Breast Cancer. In Vivo.
2022;36(6):2890–8.
19. AiErken N, Shi H juan, Zhou Y, Shao N, Zhang J, Shi Y, et
al. High PD-L1 Expression Is Closely Associated With TumorInfiltrating Lymphocytes and Leads to Good Clinical Outcomes
in Chinese Triple Negative Breast Cancer Patients. Int J Biol
Sci. 2017;13(9):1172–9.
20. De Moraes FCA, Souza MEC, Sano VKT, Moraes RA, Melo
AC. Association of tumor-infiltrating lymphocytes with clinical
outcomes in patients with triple-negative breast cancer
receiving neoadjuvant chemotherapy: a systematic review
and meta-analysis. Clin Transl Oncol. 2024 Aug
18;27(3):974–87.
21. Ni Y, Tsang JY, Shao Y, Poon IK, Tam F, Shea KH, et al.
Combining Analysis of Tumor-infiltrating Lymphocytes (TIL)
and PD-L1 Refined the Prognostication of Breast Cancer
Subtypes. The Oncologist. 2022 Apr 5;27(4):e313–27.
22. Loi S, Michiels S, Adams S, Loibl S, Budczies J, Denkert C,
et al. The journey of tumor-infiltrating lymphocytes as a
biomarker in breast cancer: clinical utility in an era of
checkpoint inhibition. Annals of Oncology. 2021
Oct;32(10):1236–44.
23. Xie Y, Xie F, Zhang L, Zhou X, Huang J, Wang F, et al.
Targeted Anti-Tumor Immunotherapy Using Tumor Infiltrating
Cells. Advanced Science. 2021 Nov;8(22):2101672
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