Analysis of PD-L1 expression in salivary duct carcinoma with its efficacy as a tumor marker

침샘관암에서 PD-L1의 발현율 분석과 종양 표지자로서의 효용성에 대한 고찰

  • Lee, Yong Ju (Yonsei University College of Medicine) ;
  • Koh, Yoon Woo (Yonsei University College of Medicine, Department of Otorhinolaryngology) ;
  • Yoon, Sun Och (Yonsei University College of Medicine, Department of Pathology) ;
  • Ryu, Hyang Joo (Yonsei University College of Medicine, Department of Pathology) ;
  • Kim, Hye Ryun (Yonsei University College of Medicine, Department of Internal Medicine) ;
  • Shin, Hyang Ae (National Health Insurance Service Ilsan Hospital)
  • 이용주 (연세대학교 의과대학 의학과) ;
  • 고윤우 (연세대학교 의과대학 이비인후-두경부외과학교실) ;
  • 윤선옥 (연세대학교 의과대학 병리과학교실) ;
  • 류향주 (연세대학교 의과대학 병리과학교실) ;
  • 김혜련 (연세대학교 의과대학 내과학교실) ;
  • 신향애 (국민건강보험 일산병원 이비인후과)
  • Received : 2019.04.11
  • Accepted : 2019.05.13
  • Published : 2019.05.31


Background/Objectives: Despite multiple approaches of treatments for salivary duct carcinoma, there has been a need for more successful treatment methods because of its poor prognosis. Treatment options like immunotherapy using new technologies have been attempted. Based on recent study results indicating that targeting programmed death receptors are effective in treating various cancers, this study aimed to identify the frequency of PD-L1 expression and its impact on survival rate in salivary duct carcinoma. Materials & Methods: We studied 33 patients with salivary gland cancer who were available for histologic specimens. We examined the expression of PD-L1 in the tissues and analyzed the association with the survival rate and the association with various clinical parameters. Results: According to this study and review of similar studies, we discovered that the expression of PD-L1 in salivary duct carcinoma was lower than other types of cancers. The impact of PD-L1 on survival rate also showed inconsistency in salivary duct carcinoma. Conclusion: Immunotherapy by PD-1/PD-L1 checkpoint blockade in salivary duct carcinoma needs further evaluation for clinical application.



  1. Kleinsasser O, Klein HJ, Hubner G. Salivary duct carcinoma: a group of salivary gland tumors analogous to mammary duct carcinoma. Arch Klin Exp Ohren Nasen Kehlkopfheid 1968;192:100-5.
  2. Jaehne M, Roeser K, Jaekel T, Schepers JD, Albert N, Loning T. Clinical and immunohistologic typing of salivary duct carcinoma: a report of 50 cases. Cancer. 2005;103:2526-33.
  3. Limaye SA, Posner MR, Krane JF, Fonfria M, Lorch JH, Dillon DA, et al. Trastuzumab for the treatment of salivary duct carcinoma. Oncologist. 2013;18:294-300.
  4. Ryu HJ, Koh YW, Yoon SO. The implications of TrkA and MET aberrations in de novo salivary duct carcinoma. Hum Pathol. 2018;81:18-25.
  5. Alotaibi AM, Alqarni MA, Alnobi A, Tarakji B. Human epidermal growth factor receptor 2 (HER2/neu) in salivary gland carcinomas: a review of literature. J Clin Diagn Res. 2015;9:ZE04-8
  6. Mukaigawa T, Hayashi R, Hashimoto K, Ugumori T, Hato N, Fujii S. Programmed death ligand-1 expression is associated with poor disease free survival in salivary gland carcinomas. J Surg Oncol. 2016;114(1):36-43.
  7. Chae YK, Pan A, Davis AA, Raparia K, Mohindra NA, Matsangou M, et al. Biomarkers for PD-1/PD-L1 Blockade Therapy in Non- Small-cell Lung Cancer: Is PD-L1 Expression a Good Marker for Patient Selection?. Clin Lung Cancer. 2016;17(5):350-361.
  8. Herbst RS, Soria JC, Kowanetz M, Fine GD, Hamid O, Gordon MS, et al. Predictive correlates of response to the anti-PD-L1 antibody MPDL3280A in cancer patients. Nature. 2014;515:563-567.
  9. Kim HR, Ha SJ, Hong MH, Heo SJ, Koh YW, Choi EC, et al. PD-L1 expression on immune cells, but not on tumor cells, is a favorable prognostic factor for head and neck cancer patients. Sci Rep. 2016;6:36956.
  10. Sato F, Akiba J, Kawahara A, Naito Y, Ono T, Takase Y, et al. The expression of programed death ligand-1 could be related with unfavorable prognosis in salivary duct carcinoma. J Oral Pathol Med. 2018;47(7):683-690.
  11. Chang H, Kim JS, Choi YJ, Cho JG, Woo JS, Kim A, et al. Overexpression of PD-L2 is associated with shorter relapse-free survival in patients with malignant salivary gland tumors. Onco Targets Ther. 2017;10:2983-2992.
  12. Harada K, Ferdous T, Ueyama Y. PD-L1 expression in malignant salivary gland tumors. BMC Cancer. 2018;18:156.
  13. Haderlein M, Scherl C, Semrau S, Lettmaier S, Hecht M, Erber R, et al. Impact of postoperative radiotherapy and HER2/new overexpression in salivary duct carcinoma : a monocentric clinicopathologic analysis. Strahlenther Onkol. 2017;193:961-970.
  14. Badoual C, Hans S, Merillon N, Van Ryswick C, Ravel P, Benhamouda N, et al. PD-1-expressing tumor-infiltrating T cells are a favorable prognostic biomarker in HPV-associated head and neck cancer. Cancer Res. 2013;73:128-138.
  15. Tsang JY, Au WL, Lo KY, Ni YB, Hlaing T, Hu J, et al. PD-L1 expression and tumor infiltrating PD-1 + lymphocytes associated with outcome in HER2 + breast cancer patients. Breast Cancer Res Treat. 2017;162:19-30.
  16. Han J, Hong Y, Lee YS. PD-L1 expression and combined status of PD-L1/PD-1-positive tumor infiltrating mononuclear cell density predict prognosis in glioblastoma patients. J Pathol Transl Med. 2017;51:40-48.
  17. Thompson RH, Dong H, Lohse CM, Leibovich BC, Blute ML, Cheville JC, et al. PD-1 is expressed by tumor-infiltrating immune cells and is associated with poor outcome for patients with renal cell carcinoma. Clin Cancer Res. 2007;13:1757-1761.
  18. Xu J, Sun HH, Fletcher CD, Hornick JL, Morgan EA, Freeman GJ, et al. Expression of programmed cell death 1 Ligands (PD-L1 and PD-L2) in Histiocytic and dendritic cell disorders. Am J Surg Pathol. 2016;40:443-453.
  19. Choueiri TK, Fay AP, Gray KP, Callea M, Ho TH, Albiges L, et al. PD-L1 expression in nonclear cell renal cell carcinoma. Ann Oncol. 2014;25:2178-2184.
  20. Garon EB, Rizvi NA, Hui R, Leighl N, Balmanoukian AS, Eder JP, et al. Pembrolizumab for the treatment of non-small-cell lung cancer. N Engl J Med. 2015;372:2018-2028.