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Expression of Programmed Cell Death Ligand 1 and Mismatch Repair Status in Ovarian Carcinomas
Madhubala Hariprasad1, Meenakshi Rao2, Poonam Abhay Elhence2
1Department of Histopathology, Northampton General Hospital, Northampton, United Kingdom.
Background:
Ovarian carcinoma is the third most common gynecological malignancy among women in India, with a poor prognosis despite advancements in treatment modalities. Immunotherapy, particularly the use of programd cell death ligand 1 (PD-L1) checkpoint inhibitors, has emerged as a promising approach. This study investigates the relationship between PD-L1 expression, mismatch repair (MMR) status, and clinicopathological features in epithelial ovarian carcinoma (EOC).
Materials And Methods:
A cohort of 50 EOC cases was analyzed for PD-L1 expression in tumor cells and tumor-infiltrating lymphocytes (TILs) using immunohistochemistry (IHC). MMR status was also assessed through IHC. Statistical correlations between PD-L1 expression, MMR deficiency (dMMR), and clinicopathological parameters were evaluated.
Results:
PD-L1 expression in tumor cells and TILs was observed in 20% and 14% of cases, respectively. PD-L1 expression in tumor cells was absent in most advanced-stage tumors (stages III and IV) and cases with extraovarian spread. dMMR was identified in 30% (n = 15) of cases, predominantly in higher-stage tumors with extraovarian spread and significant TIL presence (P = 0.007). However, PD-L1 expression in tumor cells and TILs was absent in 86.7% and 80% of dMMR cases, respectively. No significant association was found between dMMR status and PD-L1 expression in EOC.
Conclusion:
PD-L1 expression in tumor cells is predominantly observed in early-stage EOC, suggesting its potential as a prognostic marker and therapeutic target. Although dMMR status correlates with advanced-stage disease and TIL presence, it does not significantly influence PD-L1 expression in EOC. These findings highlight the importance of routinely assessing PD-L1 and MMR status to guide immunotherapeutic strategies in ovarian carcinoma.
Insights
Programmed cell death ligand 1 (PD-L1) expression in early-stage ovarian cancer may predict treatment response. Mismatch repair deficiency (dMMR) in ovarian cancer correlates with advanced stages but not PD-L1 expression.
Area of Science:
- Gynecologic Oncology
- Immunohistochemistry
- Cancer Biomarkers
Background:
- Ovarian carcinoma is a leading cause of cancer death in women in India.
- Immunotherapy targeting programmed cell death ligand 1 (PD-L1) offers a promising treatment avenue.
- Understanding PD-L1 expression and mismatch repair (MMR) status is crucial for optimizing treatment strategies.
Purpose of the Study:
- To investigate the correlation between PD-L1 expression, MMR status, and clinicopathological features in epithelial ovarian carcinoma (EOC).
- To evaluate the potential of PD-L1 and MMR status as prognostic and predictive biomarkers in EOC.
Main Methods:
- Analysis of PD-L1 expression in tumor cells and tumor-infiltrating lymphocytes (TILs) via immunohistochemistry (IHC) in 50 EOC cases.
- Assessment of MMR status using IHC.
- Statistical evaluation of associations between PD-L1 expression, MMR deficiency (dMMR), and clinicopathological parameters.
Main Results:
- PD-L1 expression was detected in 20% of tumor cells and 14% of TILs.
- PD-L1 expression was notably absent in advanced-stage EOC (III/IV) and cases with extraovarian spread.
- dMMR was found in 30% of cases, associated with advanced stage, extraovarian spread, and TIL presence (P=0.007).
- However, PD-L1 expression was largely absent in dMMR cases (86.7% in tumor cells, 80% in TILs), with no significant association found between dMMR and PD-L1 expression.
Conclusions:
- PD-L1 expression in tumor cells is more prevalent in early-stage EOC, indicating its potential as a prognostic marker and therapeutic target.
- While dMMR status correlates with advanced disease and TIL infiltration, it does not significantly impact PD-L1 expression in EOC.
- Routine assessment of PD-L1 and MMR status is recommended to guide immunotherapy decisions in ovarian cancer management.
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