Siraj Abdul K, Parvathareddy Sandeep Kumar, Annaiyappanaidu Padmanaban, Siraj Nabil, Al-Rasheed Maha, Al-Badawi Ismail A, Al-Dayel Fouad, Al-Kuraya Khawla S
Human Cancer Genomic Research, Research Center, King Faisal Specialist Hospital and Research Center, P.O. Box 3354, Riyadh 11211, Saudi Arabia.
Department of Obstetrics-Gynecology, King Faisal Specialist Hospital and Research Center, P.O. Box 3354, Riyadh 11211, Saudi Arabia.
Diagnostics (Basel). 2021 Feb 25;11(3):394. doi: 10.3390/diagnostics11030394.
Programmed death ligand 1 (PD-L1) expression in endometrial cancer (EC) tumor cells have been reported in several studies with inconsistent results. Furthermore, there is scarcity of data on the prevalence and prognostic significance of PD-L1 expression in EC from Middle Eastern ethnicity. We aimed to assess PD-L1 expression in a large cohort of Middle Eastern EC and to correlate this with clinico-pathological factors, as well as mismatch repair (MMR) protein status and patients' outcome. PD-L1 expression was investigated using immunohistochemistry on tissue microarray in an unselected cohort of 440 EC. Kaplan-Meier and logistic regression analysis were used to compare the outcome and prognostic factors. PD-L1 expression in tumor tissue was detected in 18.9% (83/440) EC cases with no impact on survival. When stratified for MMR protein status, PD-L1 expression was similar for both MMR deficient and MMR proficient ECs. However, the expression of PD-L1 in tumor cells was significantly associated with type II (non-endometrioid) histology ( = 0.0005) and lymph node metastasis ( = 0.0172). Multivariate analysis showed PD-L1 expression to be an independent risk factor for lymph node metastasis (odds ratio: 2.94; 95% CI: 1.26-6.84; = 0.0123). In conclusion, PD-L1 was strongly associated with non-endometrioid EC and was an independent prognostic marker of lymph node metastasis.
多项研究报道了程序性死亡配体1（PD-L1）在子宫内膜癌（EC）肿瘤细胞中的表达情况，但结果并不一致。此外，关于中东裔EC患者中PD-L1表达的患病率及预后意义的数据较少。我们旨在评估一大群中东EC患者中PD-L1的表达情况，并将其与临床病理因素、错配修复（MMR）蛋白状态以及患者预后相关联。在440例未经选择的EC患者队列中，通过组织微阵列免疫组化研究了PD-L1的表达情况。采用Kaplan-Meier法和逻辑回归分析比较预后和预后因素。在18.9%（83/440）的EC病例中检测到肿瘤组织中有PD-L1表达，但其对生存无影响。根据MMR蛋白状态分层时，MMR缺陷型和MMR proficient型ECs的PD-L1表达相似。然而，肿瘤细胞中PD-L1的表达与II型（非子宫内膜样）组织学（P = 0.0005）和淋巴结转移（P = 0.0172）显著相关。多变量分析显示，PD-L1表达是淋巴结转移的独立危险因素（优势比：2.94；95%置信区间：1.26 - 6.84；P = 0.0123）。总之，PD-L1与非子宫内膜样EC密切相关，是淋巴结转移的独立预后标志物。
