KEYWORDSglucose transporter 1, programmed cell death ligand 1, radiotherapy, prognosis, hypopharyngeal cancer 2 Abstract Purpose: Although the alteration of tumor immunity after radiotherapy (RT) has been studied widely in recent years, how radiotherapy mediates tumor immunity and whether glycolysis is involved in the mediation in hypopharyngeal cancer are still unclear. This study aimes to determine whether radiotherapy regulates programmed cell death ligand 1( PD-L1) partly via glucose transporter 1(GLUT-1) expression and whether PD-L1 expression predicts overall survival (OS) in patients with hypopharyngeal cancer.Methods: PD-L1, Glut-1 expression and C D4+, CD8+ T cell were detected by immunohistochemistry analysis on 47 pre-RT and 25 post-RT specimens of hypopharyngeal cancer. The changes of these indicators before and after radiotherapy were compared, and their association with overall survival of patients were analyzed. Moreover, we used siRNA-GLUT-1 to inhibit GLUT-1 expression and determined whether GLUT-1 was a key factor involved in mediation of PD-L1 expression by RT in vitro.
Results: In multivariate analysis, patients with higher PD-L1 expression (P=0.037), higher CD4+ T cell infiltration (P=0.016) and earlier clinical stage (P=0.019) had favourable OS. The PD-L1 expression and CD4+, CD8+ T cell increased significantly after RT. PD-L1 expression was correlated with Glut-1 in pre-RT (P=0.002), but not after-RT(P=0.051). The PD-L1 expression of FaDu cells was upregulated after RT, especially at 96h after RT in vitro. However, the PD-L1 expression of siRNA-GLUT-1 FaDu cells was significantly decreased at 96h after RT when compared with FaDu cells. Conclusion: The patients with high PD-L1 expression and CD4+ T cell infiltration might have favourable OS in hypopharyngeal cancer. RT could increase PD-L1 expression and alter tumor immunity, the expression of PD-L1 was correlated with Glut-1, and inhibiting GLUT-1 expression might decrease the expression of PD-L1. GLUT-1 might participate in the alteration of tumor immunity after RT.