METHODS: This retrospective study included a total of 100 ECs, collected from archived, formalin-fixed, paraffin-embedded tissue blocks of hysterectomy specimens of Egyptian females. The samples were immunohistochemically analyzed for PD-L1 expression (in both tumor cells; TCs and tumor infiltrating leucocytes; TILs) by a semiquantitative score (0 to 4), with cutoff points of (0: <1% of the cells, 1: 1% to 4%, 2: 5% to 9%, 3: 10% to 49%, and 4: ≥ 50%). Membranous staining only was considered positive.
RESULTS: PD-L1 was highly expressed in ECs (67% TCs+ and 61% TILs+), with statistically significant relationships with age, lympho-vascular space invasion (LVSI) and TILs score (P = 0.006, 0.016 and <0.005 respectively). However, no statistically significant relationships were detected between PD-L1 expression and the following parameters: histological type, histological grade, pathological stage (pT) or FIGO stage, myometrial, cervical, adnexal/serosal, parametrial involvements and nodal metastasis, as well as ESMO risk stratification system. Moreover, statistically significant relationships were achieved when correlating TILs score with tumor grade and LVSI (P = 0.034 and 0.012 respectively). Also, comparing endometrial hyperplasia (EH) PD-L1 and TCs PDL1 median scores achieved statistically significant relationship (P = 0.001).
CONCLUSIONS: Our results concluded that PD-L1 expression was greater in both TCs and TILs in a subgroup of patients that have advanced age, LVSI and are TILs-rich, identifying them as potential candidates for anti-PD-1/PD-L1 immunotherapy.
方法:这项回顾性研究共包括100个ECs,从存档中收集,福尔马林固定,埃及女性子宫切除术标本的石蜡包埋组织块。通过半定量评分(0至4)对样品的PD-L1表达进行免疫组织化学分析(在两个肿瘤细胞中;TC和肿瘤浸润白细胞;TIL),截止点为(0:<1%的细胞,1:1%到4%,2:5%到9%,3:10%至49%,和4:≥50%)。仅膜染色被认为是阳性的。
结果:PD-L1在EC中高表达(67%TC+和61%TILs+),与年龄有统计学意义的关系,淋巴管间隙侵犯(LVSI)和TILs评分(分别为P=0.006、0.016和<0.005)。然而,在PD-L1表达与以下参数之间未检测到统计学上的显着关系:组织学类型,组织学分级,病理阶段(pT)或FIGO阶段,子宫肌层,子宫颈,附件/浆膜,宫旁受累和淋巴结转移,以及ESMO风险分层系统。此外,当将TILs评分与肿瘤分级和LVSI相关联时,达到统计学显著的相关性(分别为P=0.034和0.012).此外,比较子宫内膜增生(EH)PD-L1和TCsPDL1中位评分,取得了统计学显著的相关性(P=0.001).
结论:我们的结果得出结论,在高龄患者的亚组中,TC和TILs中的PD-L1表达更高,LVSI和TIL丰富,确定它们是抗PD-1/PD-L1免疫治疗的潜在候选者。