Expression of Programmed Death-Ligand 1 in Cervical Cancer: Correlation With Histologic Subtypes and
Zahra Vahedpoor1, Amirhasan Matini1, Habibollah Rahimi2
1Autoimmune Diseases Research Center, Kashan University of Medical Sciences, Kashan, Iran.
Background:
Cervical cancer remains a significant global health challenge, with squamous cell carcinoma (SCC) and adenocarcinoma representing its predominant histologic types. Programmed death-ligand 1 (PD-L1) expression in cervical cancer has been implicated in tumor immune evasion, yet its prognostic significance remains unclear. This study aimed to evaluate PD-L1 expression in cervical cancer and its association with clinicopathological features and patient survival.
Methods:
This study included formalin-fixed, paraffin-embedded tissue samples from forty-seven patients with cervical cancer. PD-L1 expression was assessed by immunohistochemistry (IHC) and correlated with clinical data, HPV status (determined by p16 IHC and HPV DNA PCR/genotyping), and 2-year survival outcomes. Statistical analyses included Fisher's exact test and Kaplan-Meier survival analysis.
Results:
PD-L1 was expressed in 61.2% of cases, predominantly in keratinizing SCC (p = 0.006) and tumors with diffuse HPV positivity (p < 0.001). PD-L1 expression significantly correlated with advanced FIGO stage (p = 0.03) but not with age, vascular invasion, and 2-year survival. No significant survival difference was observed between PD-L1 positive and negative groups.
Conclusions:
PD-L1 is frequently expressed in cervical carcinoma, especially keratinizing SCC and HPV-diffuse tumors, but its expression was not associated with 2-year survival. The heterogeneous expression and complex tumor-immune interactions suggest that PD-L1 alone is insufficient as a prognostic biomarker. Future research integrating additional immune and molecular markers is needed to improve prognostication and therapeutic stratification.
