Portuguese Institute of Oncology in Lisbon, Urology, Lisbon.
Portuguese Institute of Oncology in Lisbon, Pathology, Lisbon.
Arch Ital Urol Androl. 2024 Oct 2;96(3):12856. doi: 10.4081/aiua.2024.12856.
Our objective was to investigate the association between programmed death-ligand (PD-L1) immunoexpression measured as a combined positive score and clinical outcomes in penile SqCC.
We retrospectively reviewed all penile SqCC cases diagnosed in our institution between 2018 and 2023. PD-L1 immunohistochemistry was performed as a qualitative assay. Immunoexpression in both tumor and immune cells equal or superior to 1 was considered positive.
A total of 34 patients with conventional penile SqCC were included. Eleven cases were HPV-associated (32.4%). Twelve cases were PD-L1 CPS < 1 and twenty-two were PD-L1 CPS ≥ 1. Nine cases (32.4%) were PD-L1 CPS ≥ 1 and p16 positive, but this did not translate in worse clinicopathological features. Larger tumors (3.0 cm in PD-L1 CPS ≥ 1 vs 2.5 cm in PD-L1 CPS < 1; p = 0.662), vascular invasion (36.4% in PD-L1 CPS ≥ 1 vs. 25.0% in PD-L1 CPS < 1; p = 0.705) and perineural invasion (40.9% in PD-L1 CPS≥1 vs. 16.7% in PD-L1 CPS < 1; p = 0.252) were associated with PD-L1 expression. Among the high-risk features, only lymph node involvement had statistical significance, with 14 out of 22 PD-L1 CPS ≥ 1 patients (63.6%) having lymph node metastases when lymphadenectomy was performed (p = 0.031). With a median follow-up of 16 months (IQR 27.5), PD-L1 CPS ≥ 1 patients had worse overall survival (53.4 months vs 75.9 months), but no statistical significance could be inferred (p = 0.188).
It is noteworthy the clinical significance of lymph node involvement in PD-L1 CPS ≥ 1 cases and a trend towards worse overall survival in this group of patients.
我们的目的是研究程序性死亡配体（PD-L1）免疫组化表达（作为综合阳性评分）与阴茎鳞癌（SqCC）临床结局之间的关系。
我们回顾性分析了 2018 年至 2023 年期间我院确诊的所有阴茎 SqCC 病例。采用定性免疫组化方法检测 PD-L1。肿瘤细胞和免疫细胞中 PD-L1 免疫表达≥1 被认为是阳性。
共纳入 34 例传统阴茎 SqCC 患者，其中 11 例（32.4%）与 HPV 相关。12 例 PD-L1 CPS＜1，22 例 PD-L1 CPS≥1。9 例（32.4%）PD-L1 CPS≥1 且 p16 阳性，但这并未导致更差的临床病理特征。较大的肿瘤（PD-L1 CPS≥1 为 3.0cm，PD-L1 CPS＜1 为 2.5cm；p=0.662）、血管侵犯（PD-L1 CPS≥1 为 36.4%，PD-L1 CPS＜1 为 25.0%；p=0.705）和神经周围侵犯（PD-L1 CPS≥1 为 40.9%，PD-L1 CPS＜1 为 16.7%；p=0.252）与 PD-L1 表达相关。在高危特征中，只有淋巴结受累具有统计学意义，22 例 PD-L1 CPS≥1 患者中有 14 例（63.6%）在进行淋巴结清扫术时出现淋巴结转移（p=0.031）。中位随访 16 个月（IQR 27.5），PD-L1 CPS≥1 患者的总生存率更差（53.4 个月 vs 75.9 个月），但无统计学意义（p=0.188）。
值得注意的是，PD-L1 CPS≥1 病例中淋巴结受累的临床意义，以及该组患者总生存率有恶化趋势。
