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01.12.2018 | Research article | Ausgabe 1/2018 Open Access

BMC Cancer 1/2018

Heterogeneity of PD-L1 expression in primary tumors and paired lymph node metastases of triple negative breast cancer

BMC Cancer > Ausgabe 1/2018
Ming Li, Anqi Li, Shuling Zhou, Yan Xu, Yaoxing Xiao, Rui Bi, Wentao Yang
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1186/​s12885-017-3916-y) contains supplementary material, which is available to authorized users.



Programmed cell death ligand 1 (PD-L1) is a potential predictive biomarker of the response to anti-PD-L1/anti- programmed cell death 1 (PD-1) therapy in multiple cancers, including triple negative breast cancer(TNBC). The purpose of this study was to investigate whether PD-L1 expression is homogenous in primary tumors(PTs) and synchronous axillary lymph node metastases(LNMs) of TNBC.


PD-L1 expression was immunohistochemically evaluated in 101 TNBC patients’ PTs and paired LNMs. PD-L1 expression in tumor cells and infiltrating immune cells or node lymphocytes in the PTs and associated LNMs was scored separately and was correlated with patients’ clinical parameters and prognoses.


PD-L1 expression exhibited spatial heterogeneity in both the tumor cells and the infiltrating immune cells or node lymphocytes of PTs and LNMs. The PD-L1 expression levels were significantly higher in the lymphocytes and tumor cells of the LNMs than in the PTs. PD-L1 expression was also more frequent among the LNMs. PD-L1 expression was associated with high grade and more stromal tumor-infiltrating lymphocytes(TILs). Furthermore, the disease-free survival and overall survival were similar between the PT- negative/LNM- positive and PT- positive/LNM- positive patients, both of which exhibited worse disease-free survival(DFS) thanPT -negative/LNM -negative patients.


The differential expression of PD-L1 between the PTs and LNMs suggests that LNMs PD-L1 status may be used to indicate whether PD-1/PD-L1-targeted therapy would be suitable for a node-positive TNBC patient in the future.
Additional file 1: Figure S1. The validation of PD-L1 antibody. (A) Western blot analysis for PD-L1 using MDA-MB-231 treated with control and PD-L1 targeting siRNAs. (B) Immunoarchitecture of a TNBC lymph nodal metastasis. PD-L1 expression was observed in the lymph node germinal centers, providing an internal positive control for staining. (TIFF 6516 kb)
Additional file 2: Table S1. Clinicopathological features of the three groups: PT-/LNM-, PT-/LNM+ and PT+/LNM+ (DOCX 19 kb)
Additional file 3: Figure S2. Kaplan–Meier survival curve for overall survival (OS) according to PD-L1 expression in PTs and LNMs. (TIFF 5345 kb)
Additional file 4: Table S2. Cox regression analysis of PD-L1 expression and clinicopathological factors predicting OS. (DOCX 15 kb)
Additional file 5: Table S3. Cox regression analysis of PD-L1 expression and clinicopathological factors predicting DFS. (DOCX 15 kb)
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