Menkiti Felix Emeka, Okani Chukwudi Onyeaghana, Onyiaorah Igwebuike Victor, Ukah Cornelius Ozobia, Menkiti Ifeoma Oluchukwu, Ihekwoaba Eric Chukwudi, Okoye Odili Aloysius, Ofiaeli Ogochukwu Chioma, Akpuaka Frank Chinedu
Department of Anatomic Pathology and Forensic Medicine, Faculty of Basic Clinical Sciences, Nnamdi Azikiwe University, Awka, Nigeria.
Department of Histopathology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria.
BMC Gastroenterol. 2025 Apr 20;25(1):277. doi: 10.1186/s12876-025-03862-7.
BACKGROUND: Colorectal cancer (CRC) incidence is rising in Nigeria, with majority of patients presenting with advanced disease. Despite promising results of PD-L1 antibody therapy in clinical trials, efficacy data exclusively derives from Caucasian populations, leaving a critical knowledge gap for African populations. This study investigated PD-L1 expression in CRC among blacks, correlating it with clinicopathologic parameters. METHODS: The immunohistochemical expression of PD-L1 was evaluated in 96 cases of CRC diagnosed between February 2022 and January 2024, using formalin-fixed paraffin-embedded (FFPE) tissue blocks. Statistical analysis was performed using SPSS version 25. The relationships between the PD-L1 expression and the clinicopathological parameters of CRC patients were determined using the chi-square test and Spearman's rank correlation. p < 0.05 was considered to be statistically significant. RESULTS: CRC showed a male: female ratio of 1:1.8, most occurred in the seventh decade and 54.17% were right-sided. Adenocarcinoma NOS accounted for 72.5%. The majority (n = 55, 57.3%) of the patients were diagnosed at an advanced stage. PD-L1 expression was observed in 86.46% of cases, significantly correlating with tumour Size (r = 0.263, p = 0.010*), histologic Grade (r = 0.446, p = 0.000*) and tumour Stage (r = 0.367, p = 0.000*). CONCLUSION: This study highlighted the high frequency of PD-L1 expression in CRC among black patients, with significant associations to clinicopathologic parameters. The findings suggest the potential benefit of PD-1/PD-L1 targeted therapies and emphasize the need for enhanced early detection and screening in Nigeria.
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