The Expression of Immune Checkpoint Inhibitors PDL-1 and CTLA-4 in Pancreatic Versus Non-Pancreatic Periampullary Adenocarcinoma: An Immunohistochemical Study | ||||
| Egyptian Journal of Cancer and Biomedical Research | ||||
| Article 13, Volume 5, Issue 2, June 2021, Page 143-152 PDF (7.67 MB) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/jcbr.2021.56525.1108 | ||||
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| Authors | ||||
Noha Mohamed El-Anwar   1; Reham Shehab El Nemr2
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| 1Pathology department, faculty of medicine Tanta University Pathology department, Armed Forces College of Medicine | ||||
| 2Pathology Department, Faculty of Medicine, Fayoum University and Pathology Department Armed Forces College of Medicine | ||||
| Abstract | ||||
| Background: Periampullary cancers constitute about 5% of gastrointestinal malignancies. They are comprised of tumors of diverse origins and are generally subdivided into pancreatic and non-pancreatic carcinomas. Immune checkpoint regulators, cytotoxic T-lymphocyte antigen 4 (CTLA-4), and the programmed cell death ligand-1 (PDL-1) have emerged as promising new targets for cancer therapeutics. Aim: This study aims to determine the possible role of immune checkpoint inhibitors PDL-1 and CTLA-4 in periampullary carcinoma of pancreatic and non-pancreatic adenocarcinoma subtypes, in an attempt to investigate the possible introduction of their related immunotherapy in the management of these tumors. Materials and Methods: Expression of immune inhibitory molecules was examined by immunohistochemistry in 40 cases including (20) pancreatic adenocarcinoma and (20) non-pancreatic adenocarcinoma. The association between markers and clinicopathological parameters was evaluated. Results: Statistically significant differences in the immunoexpression of both CTLA-4 and PDL-1 in the two studied groups were noticed with higher expression in non-pancreatic adenocarcinoma in relation to pancreatic adenocarcinoma (P=0.004, P=0.008) respectively. PDL-1 expression was positive in 15% and 55% of pancreatic and non-pancreatic adenocarcinoma cases, respectively with a significant correlation with lymph nodes metastasis in non-pancreatic adenocarcinoma cases. CTLA-4 was positive in 20% of pancreatic carcinoma with a significant correlation with lymph node metastasis, perineural invasion and T stage. In non-pancreatic periampullary adenocarcinoma, CTLA-4 was positive in 65% of cases with a significant association with lymph nodes metastasis and T stage. Conclusions: Immunotherapy using anti-PDL-1 and CTLA-4 are proposed as a novel promising management tool in non-pancreatic periampullary adenocarcinoma not in pancreatic adenocarcinomas. | ||||
| Keywords | ||||
| CTLA-4; non-pancreatic periampullary adenocarcinoma; pancreatic adenocarcinoma; PDL-1 | ||||
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