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Update regarding the role of PD-L1 in oncocytic thyroid lesions on cytological samples
  1. Marco Dell'Aquila1,
  2. Pietro Tralongo1,
  3. Alessia Granitto2,
  4. Maurizio Martini1,
  5. Sara Capodimonti1,
  6. Mariangela Curatolo1,
  7. Vincenzo Fiorentino1,
  8. Alfredo Pontecorvi3,
  9. Guido Fadda1,
  10. Celestino Pio Lombardi4,
  11. Maco Raffaelli4,
  12. Liron Pantanowitz5,
  13. Luigi Maria Larocca1,
  14. Esther Diana Rossi2
  1. 1Anatomic Pathology and Histology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy
  2. 2Anatomic Pathology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy
  3. 3Endocrinology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy
  4. 4Endocrine Surgery, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy
  5. 5Department of Pathology & Clinical Labs, University of Michigan, Ann Arbor, Michigan, USA
  1. Correspondence to Professor Esther Diana Rossi, Anatomic Pathology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome 00168, Italy; esther.rossi{at}policlinicogemelli.it

Abstract

Aims Several papers have shown that programmed death-ligand 1 (PD-L1) expression is a relevant predictive biomarker in anti-PD-L1 cancer immunotherapy. While its role in several human cancers is correlated with poor prognosis and resistance to anticancer therapies, in thyroid cancers the role of PD-L1 remains questionable. Few articles have studied PD-L1 in thyroid fine-needle aspiration cytology (FNAC), demonstrating a possible correlation with papillary thyroid carcinoma. However, its role in oncocytic thyroid lesions remains controversial. We accordingly examine the performance of PD-L1 immunostaining in liquid based cytology (LBC) from oncocytic lesions.

Methods From January 2019 to March 2021, 114 thyroid lesions diagnosed by FNAC from lesions with a predominant oncocytic component, were enrolled for evaluation by PD-L1 immunostaining on both LBC and corresponding histology samples.

Results The FNAC cohort included 51 benign (B, negative controls), 4 atypia of undetermined significance/follicular lesions of undetermined significance (AUS/FLUS), 57 follicular lesions (follicular neoplasm/suspicious for FN, FN/SFN) and 2 suspicious for malignancy (SFM) cases. Fifty-four cases (11B, 2 AUS/FLUS, 39 FN/SFN and 2 SFM) had histological follow-up including: 1B case resulted as a hyperplastic oxyphilic nodule in Hashimoto thyroiditis (HT), 10B as goitre, 2 AUS/FLUS cases as oncocytic adenomas (OAs); 39 FN/SFN included 27 OAs, 4 FA and 8 oncocytic follicular carcinoma (OFC). The two SFM cases were diagnosed on histopathology as OAs. Increased plasma membrane and cytoplasmic PD-L1 expression were found in 47 cases of the LBC cases (41.2%). Among the histological series, 67.3% of OAs and 75% of OFC had PD-L1 expression, while negative PD-L1 was found in hyperplastic oncocytic cells in HT. A positivity in more than 30% of the neoplastic cells was found in 72.9% of the cases including six OFC.

Conclusions These data suggest that PD-L1 expression is expressed in oncocytic thyroid lesions. While weak PD-L1 expression failed to discriminate benign from malignant lesions, OFC demonstrated more intense cytoplasmic and membranous expression.

  • Thyroid Diseases
  • Thyroid Neoplasms
  • Thyroid Gland

Data availability statement

All data relevant to the study are included in the article.

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Data availability statement

All data relevant to the study are included in the article.

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Footnotes

  • LP, LML and EDR are joint senior authors.

  • Handling editor Runjan Chetty.

  • Contributors EDR, LP and LML planned the study. PT, VF, AG, MM, SC and MC worked on the technical performance. MR, CPL, GF and AP revised the manuscript for contents. EDR is responsible for the overall content as the guarantor.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.