J Pathol Transl Med.  2018 Jan;52(1):9-13. 10.4132/jptm.2017.07.26.

Programmed Death-Ligand 1 Expression and Its Correlation with Lymph Node Metastasis in Papillary Thyroid Carcinoma

  • 1Department of Pathology, Gyeongsang National University Changwon Hospital, Changwon, Korea. golgy@hanmail.net
  • 2Gyeongsang National University School of Medicine, Jinju, Korea.
  • 3Gyeongsang Institute of Health Science, Jinju, Korea.
  • 4Department of Pathology, Gyeongsang National University Hospital, Jinju, Korea.
  • 5Deparment of Otorhinolaryngology, Gyeongsang National University Changwon Hospital, Changwon, Korea.
  • 6Department of Surgery, Gyeongsang National University Changwon Hospital, Changwon, Korea.


The immunotherapeutic role of programmed death-ligand 1 (PD-L1) in life expectancy in many cancers has been highlighted. However, data regarding PD-L1 expression in papillary thyroid carcinoma (PTC) are limited. In this study, we describe the PD-L1 and programmed cell death protein 1 (PD-1) expressions in PTC and analyze their correlation with lymph node (LN) metastasis.
Clinicopathological data were obtained from 116 patients with PTC who were treated in Gyeongsang National University Hospital, Jinju, Korea in 2009. Tissue microarray blocks were made using representative paraffin blocks of classical PTCs excluding follicular variants. Two pathologists graded the proportion and intensity of PD-L1 and PD-1 expression in both tumor and inflammatory cells. According to their proportions, positive PTC cells were scored as negative (0%), grade 1 (1%-50%), and grade 2 (51%-100%). Similarly, positive inflammatory cells were graded as negative (0%), grade 1 (1%-10%), and grade 2 (11%-20%). The intensity of each protein expression was simplified as positive or negative.
A statistically significant correlation exists between the proportions of PD-1 and PD-L1 expression both in papillary carcinoma (p=.001) and peritumoral lymphoid cells in the thyroid (p<.001). In addition, the proportion of PD-L1 expression in PTC cells was closely related to metastatic LNs (p=.036).
PD-L1 is a valuable predictive marker for LN metastasis in PTC. Immunomodulating therapies that inhibit PD-L1 might be an option for patients with LN metastasis.


Programmed death-ligand 1; Carcinoma, papillary; Thyroid; Lymph nodes; Neoplasm metastasis

MeSH Terms

Carcinoma, Papillary
Cell Death
Life Expectancy
Lymph Nodes*
Neoplasm Metastasis*
Thyroid Gland*
Thyroid Neoplasms*


  • Fig. 1. (A) More than one-half of papillary carcinoma cells (PTCs) show mild programmed death-ligand 1 (PD-L1) expression in the cytoplasm. There are many PTCs with strong PD-L1 expression in cellular membrane in the center of the figure. (B) Inflammatory cells that surround PTCs exhibit PD-L1 expression. (C) Most of the PTCs reveal programmed cell death protein 1 (PD-1) expression in the perinuclear cytoplasmic area. (D) Inflammatory cells in the germinal center have reactivity to PD-1.


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