Oliushina E M, Zavalishina L E, Andreeva Yu Yu, Kuznetsova O A, Moskvina L V, Frank G A
Russian Medical Academy of Continuous Professional Education, Moscow, Russia.
Arkh Patol. 2023;85(5):5-12. doi: 10.17116/patol2023850515.
Study of PD-L1 expression in squamous and adenosquamous cell cervical cancer (CC) by immunohistochemical (IHC) method, assessment of the relationship between PD-L1 tumor status and its clinical and morphological characteristics, TILs, MSI/dMMR, and HPV tumor status.
Surgical material was obtained from 41 patients with CC, on which the expression of PD-L1, proteins of the MMR system and p16 was studied by the IHC method, the TILs index was determined.
Positive PD-L1 status was found in 51.2% of the studied CC samples. In the study sample, the level of PD-L1 expression depended on the severity of lymphoid infiltration of the tumor (=0.038), it was shown that a positive PD-L1 status of CC can be expected with a TILs value greater than or equal to 50%. The age of the patients, the histological variant of the tumor, the pT and pN stage, the presence of lymphovascular invasion, and the HPV status did not statistically significantly affect the level of PD-L1 expression, however, there was an association between the PD-L1 status and the grade of CC malignancy (=0.027). The presence of the MSI/dMMR phenomenon was detected in a small percentage of carcinomas (4.9%), the PD-L1 status of these tumors was determined as positive.
A positive PD-L1 status is determined in a significant number of cases of CC, regardless of most of the studied clinical and morphological characteristics; there is a statistically significant relationship between PD-L1 expression and the degree of tumor differentiation and TILs. It has been shown that CC with the MSI/dMMR phenomenon is characterized by a positive PD-L1 status. The authors consider it necessary to study the expression of PD-L1 in patients with cervical carcinomas in order to determine the possibility of prescribing personalized therapy with immune checkpoint inhibitors.
采用免疫组织化学（IHC）方法研究宫颈鳞状细胞癌和腺鳞癌（CC）中PD-L1的表达，评估PD-L1肿瘤状态与其临床和形态学特征、肿瘤浸润淋巴细胞（TILs）、微卫星高度不稳定/错配修复缺陷（MSI/dMMR）以及人乳头瘤病毒（HPV）肿瘤状态之间的关系。
从41例CC患者获取手术材料，采用IHC方法研究PD-L1、错配修复系统蛋白和p16的表达，测定TILs指数。
在所研究的CC样本中，51.2%检测到PD-L1阳性状态。在研究样本中，PD-L1表达水平取决于肿瘤的淋巴细胞浸润程度（P=0.038），结果表明，TILs值大于或等于50%时，CC的PD-L1状态可能为阳性。患者年龄、肿瘤组织学类型、pT和pN分期、是否存在脉管浸润以及HPV状态对PD-L1表达水平无统计学显著影响，然而，PD-L1状态与CC恶性程度之间存在关联（P=0.027）。在一小部分癌（4.9%）中检测到MSI/dMMR现象，这些肿瘤的PD-L1状态被确定为阳性。
在大量CC病例中确定了PD-L1阳性状态，无论所研究的大多数临床和形态学特征如何；PD-L1表达与肿瘤分化程度和TILs之间存在统计学显著关系。已表明具有MSI/dMMR现象的CC以PD-L1阳性状态为特征。作者认为有必要研究宫颈癌患者中PD-L1的表达，以确定开具免疫检查点抑制剂个性化治疗的可能性。
