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Pd-L1 Expression in Oral Cavity Squamous Cell Carcinomas
Aasma Nalwa1, Aarathi Visakhan1, Poonam Abhay Elhence1
1Department of Pathology & Lab Medicine & Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Jodhpur, Rajasthan India.
Indian Journal of Surgical Oncology
|April 23, 2026
Summary
Programmed cell death ligand-1 (PD-L1) expression is high in Indian oral cancer patients, particularly in advanced stages. This suggests PD-L1 inhibitors may be effective immunotherapy, irrespective of HPV status.
Area of Science:
- Oncology
- Immunology
- Pathology
Background:
- Programmed cell death ligand-1 (PD-L1) is an immune checkpoint inhibitor crucial in T-cell regulation.
- PD-L1 expression is a key area of research in various cancers, including oral squamous cell carcinoma (OSCC).
Purpose of the Study:
- To investigate the role and expression levels of PD-L1 in OSCC within the Indian population.
- To explore the association between PD-L1 expression and Human Papillomavirus (HPV) status in Indian OSCC cases.
Main Methods:
- Immunohistochemistry was used to assess PD-L1 and p16 expression on OSCC resection specimens.
- Combined Positive Score (CPS) was calculated for PD-L1, with CPS ≥ 20 defined as strong positive.
- p16 positivity was defined by diffuse, strong nuclear and cytoplasmic expression in ≥ 70% of tumor cells.
Main Results:
- PD-L1 expression was detected in 86.1% of the 188 studied cases, with 67.02% showing strong expression (CPS ≥ 20).
- A significant correlation was found between higher PD-L1 expression and advanced tumor stages (T2-4) compared to early stages (T1) (p=0.014).
- No significant associations were observed between PD-L1 expression and p16 positivity, lymph node metastasis, or tumor grade.
Conclusions:
- High PD-L1 expression is prevalent in Indian OSCC patients, occurring in over 80% of cases irrespective of HPV status.
- Targeted immunotherapy using PD-L1 inhibitors shows promise as an effective treatment strategy for Indian OSCC patients, especially those with advanced disease.

