Abdul Wahab Badrul Iskandar, Shah Shamsul Azhar, Mohd Arshad Roslina, Alfian Nurwardah, Tan Geok Chin, Wong Yin Ping
Department of Pathology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia.
Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia.
Diagnostics (Basel). 2025 Apr 19;15(8):1042. doi: 10.3390/diagnostics15081042.
This study investigated PD-L1 and EZH2 immunoexpressions in endometrial carcinomas (ECs) and correlated their associations with clinicopathological parameters and five-year survival outcomes. A cross-sectional, retrospective study was conducted on all ECs diagnosed between January 2014 and December 2018. Immunohistochemical staining for PD-L1 (clone 22C3) and EZH2 was performed on tumour samples, and their expression levels were assessed. Among the 104 EC cases included, 19.2% ( = 20) overexpressed PD-L1, while 8.7% ( = 9) overexpressed EZH2. Most ( = 19/20, 95.0%) PD-L1-expressing tumour cells showed EZH2 immunonegativity. Likewise, most ( = 8/9, 88.9%) EZH2-expressing ECs were PD-L1-negative. Increased PD-L1 and EZH2 expressions in ECs were seen more frequently in women more than 60 years of age ( = 0.013 and = 0.039). EZH2 overexpression was associated with higher tumour grade ( = 0.009) and more aggressive histological subtypes ( = 0.013), while PD-L1 expression was not significantly associated with tumour grade, tumour stage, histological subtypes, and lymph node status ( > 0.05). Kaplan-Meier survival analysis revealed that PD-L1-positive ECs had a significantly better five-year overall survival (OS) rate compared to PD-L1-negative ECs ( = 0.034). Conversely, EZH2 overexpression did not correlate with survival outcomes ( > 0.05). Notably, the combination of PD-L1 and EZH2 expression patterns on ECs (PD-L1-/EZH2+) portends the worst OS compared to other combined PD-L1/EZH2 expression patterns ( = 0.05). PD-L1 immunoexpression was associated with better survival outcomes in ECs, while overexpression of EZH2 was associated with higher tumour grade and aggressive histological subtypes, suggesting their potential utility as prognostic biomarkers in ECs.
本研究调查了子宫内膜癌（EC）中PD-L1和EZH2的免疫表达情况，并将它们的相关性与临床病理参数及五年生存结果进行关联分析。对2014年1月至2018年12月期间诊断的所有EC进行了一项横断面回顾性研究。对肿瘤样本进行了PD-L1（克隆号22C3）和EZH2的免疫组织化学染色，并评估其表达水平。在纳入的104例EC病例中，19.2%（n = 20）的病例PD-L1过表达，而8.7%（n = 9）的病例EZH2过表达。大多数（n = 19/20，95.0%）表达PD-L1的肿瘤细胞显示EZH2免疫阴性。同样，大多数（n = 8/9，88.9%）表达EZH2的EC为PD-L1阴性。在60岁以上的女性中，EC中PD-L1和EZH2表达增加更为常见（P = 0.013和P = 0.039）。EZH2过表达与更高的肿瘤分级（P = 0.009）和更具侵袭性的组织学亚型（P = 0.013）相关，而PD-L1表达与肿瘤分级、肿瘤分期、组织学亚型及淋巴结状态无显著相关性（P>0.05）。Kaplan-Meier生存分析显示，与PD-L1阴性的EC相比，PD-L1阳性的EC五年总生存率（OS）显著更高（P = 0.034）。相反，EZH2过表达与生存结果无相关性（P>0.05）。值得注意的是，与其他联合的PD-L1/EZH2表达模式相比，EC上PD-L1和EZH2表达模式的组合（PD-L1-/EZH2+）预示着最差的OS（P = 0.05）。PD-L1免疫表达与EC更好的生存结果相关，而EZH2过表达与更高的肿瘤分级和侵袭性组织学亚型相关，提示它们在EC中作为预后生物标志物的潜在效用。
