Kim Yeorae, Aiob Ala, Kim Hyojin, Suh Dong Hoon, Kim Kidong, Kim Yong Beom, No Jae Hong
Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam 13620, Republic of Korea.
Department of Obstetrics and Gynecology, Galilee Medical Center, Nahariya 22100, Israel.
Biomedicines. 2023 Oct 1;11(10):2691. doi: 10.3390/biomedicines11102691.
This study investigated PD-L1 expression in endometrial cancer, its links with prognostic factors, and survival outcomes in 232 patients. Of these, 73 (31.5%) had PD-L1-positive tumors and 159 (68.5%) had PD-L1-negative tumors. PD-L1 expression significantly correlated with adverse prognostic factors. The PD-L1-positive group had higher rates of high-grade tumors (37.0% vs. 19.1%, = 0.004), deep myometrial invasion (35.6% vs. 24.4%, = 0.004), lymphovascular space invasion (LVSI) (39.7% vs. 25.6%, = 0.023), and lymph node metastasis (7.2% vs. 17.1%, = 0.024) than the PD-L1-negative group. While 5-year progression-free survival (PFS) favored the PD-L1-negative group (94.1% vs. 86.3%), this difference lacked statistical significance ( = 0.139). No significant variations emerged in overall survival (OS) ( = 0.596) or recurrence rates between the groups. Although outcomes lack statistical significance, they suggest a plausible link between PD-L1 and established adverse prognostic factors, such as histological grade, myometrial invasion depth, LVSI, and lymph node metastasis in endometrial cancer. These insights hint at PD-L1's potential as an informal prognostic indicator, potentially aiding in endometrial cancer patient management.
本研究调查了232例子宫内膜癌患者的程序性死亡受体配体1(PD-L1)表达情况、其与预后因素的关联以及生存结局。其中,73例(31.5%)为PD-L1阳性肿瘤,159例(68.5%)为PD-L1阴性肿瘤。PD-L1表达与不良预后因素显著相关。PD-L1阳性组的高级别肿瘤发生率(37.0%对19.1%,P = 0.004)、肌层深部浸润发生率(35.6%对24.4%,P = 0.004)、脉管间隙浸润(LVSI)发生率(39.7%对25.6%,P = 0.023)以及淋巴结转移发生率(7.2%对17.1%,P = 0.024)均高于PD-L1阴性组。虽然5年无进展生存期(PFS)有利于PD-L1阴性组(94.1%对86.3%),但这种差异缺乏统计学意义(P = 0.139)。两组间总生存期(OS)(P = 0.596)或复发率均无显著差异。尽管结果缺乏统计学意义,但它们提示了PD-L1与子宫内膜癌既定不良预后因素(如组织学分级、肌层浸润深度、LVSI和淋巴结转移)之间可能存在的联系。这些见解暗示了PD-L1作为一种非正式预后指标的潜力,可能有助于子宫内膜癌患者的管理。