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Low PDL1 Expression in Tumour Infiltrating Lymphocytes Predicts Local Recurrence in Oral Squamous Cell Carcinoma

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Abstract

In oral squamous cell carcinoma (OSCC), expression of PDL1 is controversial with expressions showing a positive and negative correlation with survival in previous studies. Additionally, it is unclear whether expression on the tumour or tumour infiltrating lymphocytes (TIL) is a better predictor of survival. We performed this study on a cohort of Indian patients with OSCC to determine impact of PDL1 expression on survival. Retrospective analysis of 64 patients of OSCC treated with curative intent surgery with or without adjuvant therapy was performed. Stored tissue blocks were extracted and quantitative immunohistochemistry was performed for PDL1 expression separately on the tumour and the TIL using commercially available Dako kits. Correlation of clinical and pathological variables with PDL1 expression was performed using chi-square test. Survival analysis was performed using Kaplan-Meier method and Cox proportional hazards ratio. In our cohort, PDL1 expression was low, both in tumour (92% had <1% expression) and TIL (56% had <1% expression). Tumour low PDL1 expression (<1%) was associated with a higher risk of lymphovascular invasion (p = 0.044) and bone invasion (p = 0.01) but did not impact survival. Low TIL PDL1 expression (<1%) was more common in younger patients (<45 years) (p = 0.023) significantly predicting local recurrence (p = 0.02). PDL1 expression in OSCC was low. Low TIL PDL1 was common in younger patients and predicted local recurrence. Further study is required to better understand the relationship between age, tumour microenvironment and local recurrence.

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Authors and Affiliations

  1. Department of Head and Neck Oncology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, India

    Narayana Subramaniam, Krishnakumar Thankappan, Deepak Balasubramanian & Subramania Iyer

  2. Department of Pathology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, India

    Ajit Nambiar

  3. Sankhya Sciences, S-005 Krishna Greens, Dodda Bommasandra, Bangalore, 560089, India

    Sujan Dhar

  4. Amrita Institute of Nanosciences and Molecular Medicine, Amrita Vishwa Vidyapeetham, Kochi, India

    Manzoor Koyakutty

  5. Tumour Immunology, Mazumdar Shaw Medical Foundation, Bangalore, India

    Manjula Das

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  1. Narayana Subramaniam
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  2. Ajit Nambiar
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  6. Deepak Balasubramanian
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Correspondence to Subramania Iyer.

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Institution where work was done: Amrita Institute of Medical Sciences, Kochi, Kerala, India and Mazumdar Shaw Medical Foundation, Bangalore, India

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Subramaniam, N., Nambiar, A., Dhar, S. et al. Low PDL1 Expression in Tumour Infiltrating Lymphocytes Predicts Local Recurrence in Oral Squamous Cell Carcinoma. Indian J Surg Oncol 12, 408–414 (2021). https://doi.org/10.1007/s13193-021-01333-5

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