Folate Receptor Alpha Expression and the Tumor Immune Microenvironment in Patients with Cervical Cancer.

Area of Science:

• Oncology
• Immunology
• Pathology

Background:

• Folate receptor alpha (FRα) is a cell-surface protein and a potential cancer treatment target.
• Understanding FRα's role in the tumor immune microenvironment is crucial for cervical cancer therapy.

Purpose of the Study:

• To investigate the association between FRα expression and the tumor immune microenvironment in cervical cancer patients.
• To explore the correlation between FRα, PD-L1 expression, and patient prognosis.

Main Methods:

• Examined 123 cervical cancer tumor sections (squamous cell carcinoma and non-SCC).
• Assessed FRα expression via immunohistochemistry (clone 26B3).
• Evaluated PD-L1 expression (Combined Positive Score - CPS), CD3, and CD8 cell densities.

Main Results:

• FRα positivity was found in 72.4% of patients, varying by histology (55.2% SCC vs. 92.9% non-SCC).
• PD-L1 positivity (CPS ≥1) was observed in 75.6%, more frequent in SCC (83.5% vs. 66.1%).
• FRα expression showed weak negative correlations with PD-L1 (r=-0.22) and CD8+ cells (r=-0.19). FRα-high correlated with poor prognosis, especially in PD-L1 CPS ≥10 groups (HR: 4.10).

Conclusions:

• FRα expression is higher in cervical cancer patients with PD-L1 CPS <10 compared to those with CPS ≥10.
• Targeting FRα may represent a viable therapeutic strategy for cervical cancer patients with low or negative PD-L1 expression.