Pathology Department, Maputo Central Hospital, Maputo, Mozambique.
School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
Sci Rep. 2024 Jun 5;14(1):12974. doi: 10.1038/s41598-024-63595-7.
Programmed death-ligand 1 (PD-L1) is overexpressed in squamous cervical cancer (SCC) and can be used for targeted immunotherapy. The highest mortality rates of SCC are reported in sub-Saharan Africa, where Human immunodeficiency virus (HIV) prevalence is high. In Mozambique most SCC patients present at advanced stages. Thus, there is a need to introduce new treatment options. However, immunocompromised patients were frequently excluded in previous clinical trials. Our aim was to determine if PD-L1 expression in SCC is as prevalent among women living with HIV (WLWH) as among other patients. 575 SCC from Maputo Central Hospital were included. HIV status was available in 266 (46%) cases PD-L1 expression was scored through tumour proportion score (TPS) and combined positive score (CPS). PD-L1 was positive in 20.1% of the cases (n = 110), TPS (score ≥ 25%) and in 26.3% (n = 144), CPS (score ≥ 1). Stratifying according to the HIV status, WLWH were TPS positive in 16.7%, compared to 20.9%, p = 0.43, and concerning CPS 21.1% versus 28.7%, p = 0.19, respectively. PD-L1 status was not influenced by stage, Ki-67 or p16, CD8 expression influenced only CPS status. Our data indicates that the documented effect of PD-L1 therapy on SCC should be confirmed in randomized clinical trials in an HIV endemic milieu.
程序性死亡配体 1（PD-L1）在鳞状宫颈癌（SCC）中过表达，可用于靶向免疫治疗。SCC 的死亡率最高的报告在撒哈拉以南非洲，那里艾滋病毒（HIV）流行率很高。在莫桑比克，大多数 SCC 患者处于晚期。因此，需要引入新的治疗方案。然而，免疫功能低下的患者在以前的临床试验中经常被排除在外。我们的目的是确定 PD-L1 在 SCC 中的表达在 HIV 阳性的妇女（WLWH）中是否与其他患者一样普遍。共纳入莫桑比克中央医院的 575 例 SCC。在 266 例（46%）病例中可获得 HIV 状态，通过肿瘤比例评分（TPS）和联合阳性评分（CPS）对 PD-L1 表达进行评分。20.1%的病例（n=110）PD-L1 阳性，TPS（评分≥25%）阳性率为 26.3%（n=144），CPS（评分≥1）阳性率为 26.3%。根据 HIV 状态分层，WLWH 的 TPS 阳性率为 16.7%，而 CPS 阳性率为 21.1%，分别为 20.9%（p=0.43）和 28.7%（p=0.19）。PD-L1 状态不受分期、Ki-67 或 p16 影响，CD8 表达仅影响 CPS 状态。我们的数据表明，在 HIV 流行环境中，应在随机临床试验中确认 PD-L1 治疗 SCC 的已记录效果。
