Gastrointestinal nöroendokrin tümörlerde PD-L1, MMR ve EGFR ekspresyonu

Year 2024, Volume: 49 Issue: 2, 400 - 406, 30.06.2024

Sevil Karabağ , Meltem Öznur

https://doi.org/10.17826/cumj.1445549

Abstract

Amaç: Literatürde gastrointestinal nöroendokrin tümörlerle (NET) ilgili kısıtlı çalışma bulunmaktadır. Bu çalışmada gastrointestinal sistem yerleşimli G1, G2 ve G3 nöroendokrin tümörlerde PD-L1 ve EGFR ekspresyonunu saptamak, gradeler arasındaki ilişkiyi incelemek, MMR protein kaybını ve bunun PD-L1 ile ilişkisini araştırmayı amaçladık.
Gereç ve Yöntem: Bu çalışmaya Ocak 2017 ile Ocak 2021 tarihleri arasında primer gastrointestinal NET tanısı konulan tüm hastalar dahil edildi. PD-L1, EGFR, MLH1, MSH2, MSH6 ve PMS2'yi immünohistokimya ile değerlendirdik. Çalışmaya toplam 30 hasta dahil edildi.
Bulgular: Olgular mide, pankreas, kolon, apendiks ve karaciğer yerleşimli idi. Olguların 14 (47%) G1, 7(23%) si G2, 9 (30%) u G3 nöroendokrin tümördü. Tümör ve/veya tümör mikroçevresi immün hücrelerde(TMIC) G1 dört, G2 iki, G3 iki olguda olmak üzere toplam 8 olguda (28%) PD-L1 ekspresyonu saptandı. Histolojik grade ile PD-L1 ekspresyonu arasında anlamlı ilişki saptanmadı. Olguların 16’sında (53%) en az bir MMR ekspresyonunda kayıp izlendi. PD-L1 ekspresyonu olan 8 olgunun beşinde MMR kaybı saptandı, üçünde izlenmedi. Hiçbir olguda EGFR ekspresyonu saptanmadı.
Sonuç: Gastrointestinal NET'lerin %53'ünde MMR protein kaybı ve %27'sinde PD-L1 ekspresyonu gözlemledik. Çalışmamızın, Mikrosatellit instable NET'lerde bir tedavi alternatifi olabilecek immün kontrol noktası inhibitörleri ile ilgili gelecekteki çalışmalara öncü olabileceğini düşünmekteyiz.

Keywords

Nöroendokrin tümör, PD-L1, MMR, EGFR, immunohistokimya

Ethical Statement

The study (protocol-2021.94.04.12) was approved by the Non-Interventional Clinical Trials Ethics Committee.

Supporting Institution

The authors received no financial support for the research.

Thanks

The authors thank Dr Ayşegül İsal Arslan for sharing her neuroendocrine carcinoma cases for this research.

PD-L1, MMR, and EGFR expression in gastrointestinal neuroendocrine tumors

Abstract

Purpose: There are limited studies on gastrointestinal neuroendocrine tumors (NETs) in the literature. This study aimed to determine PD-L1 and EGFR expression in primary G1 and G2 NETs and neuroendocrine carcinoma located in the gastrointestinal system, explore the relationship between grades, and investigate the loss of DNA mismatch repair (MMR) protein expression and its association with PD-L1 expression.
Materials and Methods: All patients diagnosed with primary gastrointestinal NETs between January 2017 and January 2021 were included in this study. The study evaluated the protein expression of PD-L1, EGFR, MLH1, MSH2, MSH6, and PMS2 by immunohistochemistry. A total of 30 patients were included in the study.
Results: PD-L1 expression was detected in tumor cells and/or tumor microenvironment immune cells in 8 cases (28%), consisting of four G1, two G2, and two NEC cases. There was no significant relationship between histological grade and PD-L1 expression. A loss of expression of at least one MMR protein was noted in 16 cases (53%). A loss of MMR protein expression was detected in five of the eight cases with PD-L1 expression. EGFR expression was not detected in any of the cases.
Conclusion: The study revealed a loss of MMR protein expression in 53% and PD-L1 expression in 27% of gastrointestinal NETs. This study might be a pioneer for future studies on immune checkpoint inhibitors in microsatellite-unstable NETs, thereby contributing to providing a treatment alternative for this group of patients.

Keywords

Neuroendocrin tumors, PD-L1, MMR, EGFR, immunohistochemistry

Ethical Statement

The study (protocol-2021.94.04.12) was approved by the Non-Interventional Clinical Trials Ethics Committee.

Supporting Institution

The authors received no financial support for the research.

Thanks

The authors thank Dr Ayşegül İsal Arslan for sharing her neuroendocrine carcinoma cases for this research.

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