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The impact of programmed cell death-ligand 1 (PD-L1) and CD8 expression in grade 3 endometrial carcinomas

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Abstract

Background

To evaluate the expression of programmed cell death-ligand 1 (PD-L1) and CD8 in high-grade endometrial carcinomas and relate it to several clinicopathological parameters.

Methods

One hundred and one (101) patients with high-grade endometrial carcinomas who were completely surgically staged were included in this study. PD-L1 and CD8 + expression was evaluated by immunohistochemistry.

Results

In our cohort, 47 women (46.5%) had endometrioid carcinomas and 54 patients (53.5%) were diagnosed with non-endometrioid cancers. In endometrioid carcinomas, there was a significantly higher rate of positivity for PD-L1 expression (p = 0.042) and of intraepithelial CD8 + cell counts (p = 0.004) as opposed to non-endometrioid cancers. There were no significant relationships with any of the other clinicopathological features under study. Univariate and multivariate analysis revealed that only high intraepithelial CD8 + counts (p = 0.01) was associated with longer progression-free survival. Tumors positive for PD-L1 and high intraepithelial CD8 expression were mainly of endometrioid histology, whilst PD-L1-positive/CD8 low and PD-L1-negative/CD8 low tumors were mostly non-endometrioid carcinomas (p = 0.01). PD-L1 negative/CD8 high tumors had the longest progression-free survival (p = 0.032).

Conclusions

In grade 3 endometrial carcinomas, both of endometrioid and non-endometrioid type, high intraepithelial CD8 + counts represent an independent favorable prognostic factor and when related to PD-L1-negative tumors, a longer progression-free survival can be predicted. Immunotherapy could probably be considered for PD-L1-positive/CD8 + high tumors, which were mostly of endometrioid histology.

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Acknowledgements

This research work was supported by the Onassis Foundation—Scholarship ID: G ZO 001-1/2018-2019.

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Authors and Affiliations

  1. Pathology Department, National and Kapodistrian University of Athens, 75 Mikras Asias St, 11527, Athens, Greece

    Stylianos Vagios, Afroditi Nonni & Kitty Pavlakis

  2. Pathology Department, “IASO” Women’s Hospital, 37-39 Kifisias Ave, 15123, Athens, Greece

    Petros Yiannou, Triada Doulgeraki & Kitty Pavlakis

  3. Pathology Department, Venizeleio-Pananeio General Hospital, 44 Knossos Ave, 71409, Heraklion, Crete, Greece

    Elpida Giannikaki

  4. Oncology Unit, 2nd Department of Surgery, Aretaieion Hospital, National and Kapodistrian University of Athens, 71 Vas. Sophias Ave, 11528, Athens, Greece

    Christos Papadimitriou

  5. 1st Department of Obstetrics and Gynecology, Alexandra Hospital, National and Kapodistrian University of Athens, 80 Vas. Sophias Ave, 11528, Athens, Greece

    Alexandros Rodolakis

  6. Department of Gynecological Oncology, “IASO” Women’s Hospital, 37-39 Kifisias Ave, 15123, Athens, Greece

    Athanassios Vlachos

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  1. Stylianos Vagios
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Vagios, S., Yiannou, P., Giannikaki, E. et al. The impact of programmed cell death-ligand 1 (PD-L1) and CD8 expression in grade 3 endometrial carcinomas. Int J Clin Oncol 24, 1419–1428 (2019). https://doi.org/10.1007/s10147-019-01484-0

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