Programmed Death Ligand-1 (PD-L1) Expression in Cervical Squamous Cell Carcinoma: Does it Correlate With Outcomes?

Area of Science:

• Oncology
• Immunology
• Pathology

Background:

• Cervical cancer is a leading gynecological malignancy.
• Programmed death ligand-1 (PD-L1) upregulation is linked to poor outcomes in various cancers.
• Limited data exists on PD-L1 expression and clinical outcomes in cervical squamous cell carcinoma (CSCC).

Purpose of the Study:

• To investigate the correlation between PD-L1 expression and clinicopathologic factors in invasive CSCC.
• To evaluate the association of PD-L1 expression with survival outcomes in CSCC patients.

Main Methods:

• Seventy-three CSCC cases were immunostained for PD-L1.
• Combined Positive Score (CPS) was used to quantify PD-L1 expression (≥1 and ≥10 cut-offs).
• Kaplan-Meier curves and Cox regression analysis were employed to assess survival and prognostic factors.

Main Results:

• PD-L1 positivity was observed in 71.2% (CPS ≥1) and 31.5% (CPS ≥10) of cases.
• PD-L1 positive patients, particularly those with CPS ≥10, presented with higher disease stages.
• A CPS ≥10 cut-off showed significantly lower 5-year progression-free survival (P=0.034) and overall survival (P=0.012).
• Only disease stage emerged as a significant independent prognostic factor for adverse overall survival on multivariate analysis.

Conclusions:

• PD-L1 expression is frequent in CSCC and associated with advanced disease.
• Disease stage is a critical independent prognostic indicator for adverse outcomes in CSCC.
• The findings suggest potential utility of PD-L1 targeted therapy for CSCC patients.