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Impact of Neoadjuvant Therapy on PD-L1 Expression in Triple-Negative Breast Cancer and Correlation with Clinicopathological Factors

医学 内科学 乳腺癌 肿瘤科 免疫组织化学 Ki-67 相关性 三阴性乳腺癌 病态的 阶段(地层学) 化疗 新辅助治疗 胃肠病学 癌症 病理 生物 古生物学 数学 几何学
作者
Nevena Ilieva,Mina Pencheva,Hristo Hadzhiev,Desislava Tashkova,Elena Daskalova,Pencho Georgiev,Sylvia Genova
出处
期刊:Diagnostics [Multidisciplinary Digital Publishing Institute]
卷期号:14 (23): 2672-2672 被引量:2
标识
DOI:10.3390/diagnostics14232672
摘要

Background: This study aims to deliver more insights on the impact of neoadjuvant treatment on Pd-L1 expression and to evaluate its correlation with clinicopathological factors. Methods: We reviewed 88 TNBC cases for the period 2021–2023. Data on age, tumor size, stage, and treatment were collected. Histological slides were assessed for subtype, grade, and TILs. A total of 48 received neoadjuvant treatment. HER2 and Ki67 were evaluated via immunohistochemistry. PD-L1 expression was tested on primary and residual tumors. Statistical analysis was performed using IBM SPSS (p < 0.05). Results: In this study, PD-L1 positive expression was found in 44.3% of primary tumors, with 52.9% of initially positive cases losing expression post-treatment. TILs were significantly higher in PD-L1-positive tumors (mean 41.79% vs. 27.55%, p = 0.001). A notable correlation was found between PD-L1 expression and Ki-67 proliferation index, with PD-L1-positive tumors having a median Ki-67 of 64.49 compared to 52.86 in negative cases (p = 0.015). Neoadjuvant immunotherapy led to a lower mean residual cancer burden (0.95 vs. 2.55, p = 0.002) compared to chemotherapy alone. Higher Ki-67 levels (≥50%) were associated with better treatment outcomes, showing a mean RCB score of 1.60 versus 3.16 for lower levels (p = 0.022). HER2-negative cases had a higher prevalence of favorable pathological response (54.5%) compared to HER2-low tumors (25%, p = 0.048), because of the strong correlation to high proliferative index. Conclusions: In conclusion, PD-L1 expression in TNBC shows significant discordance post-treatment, highlighting the need for routine testing and further research on predictive biomarkers.
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