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. 2023 Feb 13;18(2):e0281647.
doi: 10.1371/journal.pone.0281647. eCollection 2023.

CD8/PD-L1 immunohistochemical reactivity and gene alterations in cutaneous squamous cell carcinoma

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CD8/PD-L1 immunohistochemical reactivity and gene alterations in cutaneous squamous cell carcinoma

Haruto Nishida et al. PLoS One. .

Abstract

In recent years, several immune checkpoint inhibitors targeting programmed death-ligand 1 (PD-L1) or PD-1 have been developed for cancer therapy. The genetic background of tumors and factors that influence PD-L1 expression in tumor tissues are not yet elucidated in cutaneous squamous cell carcinoma (cSCC). CD8-positive tumor-infiltrating lymphocytes (TILs) are known to be related to tumor immunity. Here, we aimed to study the relationship between CD8/PD-L1 immunohistochemical reactivity and gene alterations in cSCC. Tumorigenic genes were examined to identify gene alterations using next-generation sequencing (NGS). We collected 27 cSCC tissue samples (from 13 metastatic and 14 non-metastatic patients at primary diagnosis). We performed immunohistochemical staining for CD8 and PD-L1, and NGS using a commercially available sequencing panel (Illumina Cancer Hotspot Panel V2) that targets 50 cancer-associated genes. Immunohistochemically, CD8-positive TILs showed a high positive score in cSCC without metastasis; in these cases, cSCC occurred predominantly in sun-exposed areas, the tumor size was smaller, and the total gene variation numbers were notably low. The tumor depth, PD-L1 positivity, and gene variation number with or without tumor metastasis were not related, but the gene variation number tended to be higher in cSCCs arising in non-sun-exposed areas. Tumor metastasis was more common in cSCC arising in non-sun-exposed areas, which decreased the number of TILs or CD8-positive cells. From a genetic perspective, the total gene alterations were higher in cSCC with metastasis. Among them, ERBB4 and NPM1 are presumably involved in cSCC tumorigenesis; in addition, GNAQ, GNAS, JAK2, NRAS, IDH2, and CTNNB1 may be related to tumor metastasis. These results provide information on potential genes that can be targeted for cSCC therapy and on immune checkpoint inhibitors that may be used for cSCC therapy.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Immunohistochemical analysis of CD8 (×40).
Immunohistochemical analysis indicating that CD8-positive cells (brown) surrounded and invaded tumor nests. Images of sections with staining scored as 1 (a) and 0 (b). The nuclei were counterstained with hematoxylin.
Fig 2
Fig 2. Immunohistochemical analysis of PD-L1 (×40).
In the assessment of PD-L1 positivity (brown), the score was 1 when positive staining of the membrane was detected in >5% of the tumor cells (a), and 0 otherwise (b). The nuclei were counterstained with hematoxylin; red line shows the tumor border.

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Grants: This study was supported by the KAKENHI grant from the Japan Society for the Promotion of Science KAKENHI Grant (Number 20K16195). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.