PD-L1 Expression Predicts a Distinct Prognosis in Krukenberg Tumor with Corresponding Origins

Area of Science:

• Oncology
• Immunology
• Pathology

Background:

• Krukenberg tumors (KTs) are rare ovarian metastases, often from gastrointestinal cancers, with limited treatment options.
• Programmed death-1 (PD-1)/PD-L1 inhibitors show promise for metastatic cancers.
• Understanding PD-L1 expression in KTs is crucial for developing immune-based therapies.

Purpose of the Study:

• To evaluate Programmed Death-Ligand 1 (PD-L1) expression and T cell infiltration in Krukenberg tumors (KTs) and their primary tumors.
• To assess the prognostic implications of PD-L1 expression and CD8+ T cell density in KTs.
• To investigate the relationship between PD-L1 gene copy number variations and PD-L1 expression in KTs.

Main Methods:

• Immunohistochemical analysis of PD-L1 expression and CD8+ T cell infiltration in KTs and primary tumors.
• Correlation analysis of PD-L1 status and CD8+ T cell density with patient survival.
• Analysis of PD-L1 gene copy number variations in KTs.

Main Results:

• Positive PD-L1 expression was found in 25.7% of KTs from gastric carcinomas (GCs) and 66.7% from colorectal carcinomas (CRCs).
• PD-L1 expression in GCs was linked to poor prognosis, while in CRCs, it indicated an improved prognosis.
• CD8+ T cell densities were significantly correlated between primary tumors and their corresponding KTs. PD-L1 expression was higher with gene copy number gains.

Conclusions:

• PD-L1 expression in KTs varies by primary tumor origin (GC vs. CRC), impacting prognosis differently.
• CD8+ T cell infiltration is consistent between primary tumors and KTs.
• These findings highlight potential targets for immune-based therapies in Krukenberg tumors.