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Programmed Death-1 Pathway in Orbital Invasion of Cutaneous Carcinomas

Wladis, Edward, J., M.D., F.A.C.S.*; Lee, Joshua, A., B.A.; Carlson, J., Andrew, M.D.; Martino, Nina, B.A.§; Adam, Alejandro, P., Ph.D.†§

Ophthalmic Plastic and Reconstructive Surgery: March/April 2018 - Volume 34 - Issue 2 - p 110–113
doi: 10.1097/IOP.0000000000000880
Original Investigations
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Purpose: The programmed death-1 pathway negatively regulates the immune system. Previous reports have indicated worse tumor-related outcomes with increased expression of the ligand for this pathway. This study was undertaken to assess the role of the PD pathway in cutaneous malignancies that invade the orbit.

Methods: Immunohistochemical staining for the programmed death-1 receptor and ligand was performed on exenteration specimens of invasive cutaneous orbital malignancies (n = 12) and nodular basal cell carcinoma (n = 10). The numbers of positively-staining cells/40× field were counted across 5 consecutive fields, and statistical analyses were performed to compare the differences between the 2 groups.

Results: Programmed death-1 receptor positivity was seen in means of 30.9 cells/40× field and 62.4 cells/40× field for nodular basal cell carcinomas and invasive malignancies, respectively (p = 0.0046). A mean of 4.54 cells/40× field stained positively for the programmed death-1 ligand in nodular basal cell carcinoma, whereas a mean of 46.4 cells/40× field stained positively for programmed cell death ligand-1 in orbital invasive cutaneous carcinomas (p = 0.0015). Both of these differences were statistically significant.

Conclusions: Both the programmed death-1 receptor and its ligand are enriched in invasive cutaneous malignancies. This finding indicates that negative regulation of the immune system likely prohibits tumor surveillance, and facilitates increasing aggressiveness and invasion of cutaneous malignancies.

As compared with more indolent disease, cutaneous malignancies that invade the orbit are associated with increased expression of the programmed death-1 receptor and ligand.

*Ophthalmic Plastic Surgery, Lions Eye Institute, Department of Ophthalmology, Lions Eye Institute, Department of Ophthalmology, Division of Dermatopathology, Department of Pathology, and §Molecular and Cellular Physiology, Albany Medical College, Albany, New York, U.S.A.

Accepted for publication December 30, 2016.

This study is not under consideration for publication elsewhere. The research reported in this manuscript was presented at the 2016 Fall meeting of the American Society of Ophthalmic Plastic and Reconstructive Surgery.

The authors have no financial or conflicts of interest to disclose.

Address correspondence and reprint requests to Edward J. Wladis, M.D., F.A.C.S., 1220 New Scotland Road, Suite 302, Slingerlands, NY 12159. E-mail: tedwladis@gmail.com

© 2018 by The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc., All rights reserved.