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Published on: September 25, 2018
Immunohistochemical Evaluation of PD-L1 Expression in Complex Atypical Hyperplasia and Early-Stage Endometrial Cancer
Levent Akman1, Mert Acar2, Gurdeniz Serin3
1Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Ege University, Izmir, Turkey.
Introduction:
The study aims to evaluate programmed cell death ligand-1 (PD-L1) expression in complex atypical hyperplasia and early-stage endometrial cancer and to assess its association with tumor grade.
Materials And Methods:
This retrospective study was conducted at a single tertiary university hospital and included hysterectomy specimens obtained between 2010 and 2020. A total of 80 cases were analyzed: 20 with complex atypical hyperplasia and 60 with Stage IA endometrioid endometrial cancer, comprising 20 Grade 1, 20 Grade 2, and 20 Grade 3 tumors. All specimens underwent immunohistochemical staining with the PD-L1 (22C3) antibody, and PD-L1 expression was assessed using the combined positive score.
Results:
PD-L1 expression was absent in complex atypical hyperplasia but present in 4 of 20 Grade 1 cases (20%), 6 of 20 Grade 2 cases (30%), and 16 of 20 Grade 3 cases (80%). PD-L1 positivity increased significantly with higher tumor grade (p < 0.001). No significant associations were identified between PD-L1 expression and patient age, tumor diameter, depth of myometrial invasion, endometrial confinement, or lymphovascular invasion.
Discussion:
PD-L1 expression appears to be detectable in early-stage endometrioid endometrial cancer and may increase with tumor grade, suggesting early immune checkpoint activity.
Conclusion:
PD-L1 expression may be associated with tumor grade in early-stage endometrioid endometrial cancer. However, its clinical significance remains unclear. These findings may be relevant in the context of fertility- preserving management and require further investigation.
