The Prognostic Impact of High Soluble Programmed Death Ligand 1 Levels in Patients with Hepato-Biliary-Pancreatic Cancer

Original Article
Introduction: Several reports revealed that the high soluble programmed death-ligand 1(sPD-L1) level was a risk factor for poor prognosis in various tumors. To date, the clinicopathologic and prognostic impact of the sPD-L1 level in patients with hepatobiliary-pancreatic cancer have not been determined. Methods: A total of 119 patients (66 patients with hepatocellular carcinoma, 23 patients with cholangiocarcinoma, and 30 patients with pancreatic cancer) who were treated at the Toho University Omori Hospital (Tokyo, Japan) from 2008 to 2016 were retrospectively analyzed. The sPD-L1 levels were measured using an enzyme-linked immunosorbent assay for PD-L1 to evaluate the clinicopathologic and prognostic impact. Results: The sPD-L1 levels were significantly higher in the low-albumin group than in the normal-albumin group. According to the stages in hepatocellular carcinoma and cholangiocarcinoma, no significant differences were observed in the sPD-L1 levels, which gradually increased according to the stage in pancreatic cancer. Using a cut-off value of 81.6 pg/mL for the sPD-L1 level, the high sPD-L1 group showed a significantly worse prognosis compared with the low-sPD-L1 group in patients with pancreatic cancer. Multivariate analysis identified sPD-L1 level ≧ 81.6 mg/dL (p = 0.047) as an independent predictor of poor overall survival in patients with pancreatic cancer. Conclusions: Using a cut-off value of 81.6 pg/mL for the sPD-L1 level, high sPD-L1 levels were independently associated with poor prognosis in patients with pancreatic cancer. However, this association in hepatocellular carcinoma or cholangiocarcinoma was not clear.