Vol 61, No 4 (2023)
Original paper
Published online: 2023-12-11
Correlation between stromal Th and Tc lymphocytes and PD-L1 expression in early breast cancer tumors
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Abstract
Introduction. Prognostic and predictive value of PD-L1 as a biomarker in breast cancer remains controversial. While
some studies suggest its association with negative prognostic parameters, others reported a highly significant association
between PD-L1 expression and tumor-infiltrating lymphocytes, which are known to be an independent favorable
prognostic factor. The aim of present study is to examine the relationship between immune response markers and PD-L1
expression in early breast cancer.
Material and methods. Immunohistochemical expression of PD-L1, along with density and composition of stromal
lymphocytic infiltrate and peritumoral lymphoid aggregates was analyzed in 95 samples of invasive breast cancer.
Results. A strong positive correlation between PD-L1 expression and the density of stromal lymphocytic infiltrate and
peritumoral lymphoid aggregates was identified and a cut-off value of 53% coverage of tumor stroma by lymphocytes,
with which PD-L1 positivity can be predicted with excellent diagnostic accuracy, was determined for the first time
using statistical methods. Additionally, PD-L1 positivity was observed significantly more often in tumors with higher
absolute number of both CD4 and CD8 T-lymphocytes in the stromal infiltrate. No significant correlation with molecular
subtype of breast cancer was found.
Conclusions. Our results indicate that the density of stromal lymphocytic infiltrate might be a better predictor of PD-L1
positivity in early breast cancer than the molecular subtype and that the key to the optimization of PD-L1 as a biomarker
in breast cancer lies in its interpretation in the context of other immune response markers.
Keywords: PD-L1early breast cancertumor-infiltrating lymphocytesCD4 lymphocytesCD8 lymphocyteperitumoral lymphoid aggregates
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