Programmed Death Ligand 1 (PD-L1) Expression in Epithelial Ovarian Cancer: A Comparison of Type I and Type II Tumors

Abstract

Objective: To examine the expression of programmed death ligand 1 (PD-L1) in type I and type II epithelial ovarian cancers (EOC) and its associations with outcomes. Methods: Records of 132 women with EOC were reviewed. Immunostaining of PD-L1 was performed with formalin-fixed, paraffin-embedded specimens. Expression of PD-L1 was classified into four categories (0; 1+; 2+; 3+) according to intensity of expression. Expression of PD-L1 ≥2+ was deemed to be high. Results: Of the 132 women, 75 (56.8%) and 57 (43.2%) women had type I and type II tumors, respectively. Approximately 70% of cases exhibited high PD-L1 expression. There was no significant difference in the rate of high PD-L1 expression between the two EOC types (65.3% versus 59.6%). In type I tumors, high PD-L1 expression was associated with more advanced stages (51.0% versus 34.6%), greater recurrence (46.9% versus 26.9%), and shorter median progression-free survival (27 months versus 62 months) than low expression. In type II tumors, there were no apparent differences between high and low expression of PD-L1 in terms of the percentage of advanced-stage tumors (82.6% versus 79.4%), recurrence (56.5% versus 58.8%), and median progression-free survival (21 months versus 24 months). Conclusion: high PD-L1 expression is associated with worse oncological outcomes in type I EOC. This finding emphasizes the merit of further studies to confirm this promising result and to determine the potential role of PD-L1 blockade therapy in type I EOC.

Clinical and Prognostic Value of Antigen-Presenting Cells with PD-L1/PD-L2 Expression in Ovarian Cancer Patients

“…Our results did not demonstrate relationships between the PD-L1 expression on mDCs and pDCs and the clinicopathological characteristics (including the FIGO stage, grade, and type of OC) and the clinical data of the OC patients (i.e., age, Ca125 concentration, menopausal status). Similarly, using immunohistochemistry, Nhokaew and co-workers demonstrated no relationships between the PD-L1 expression and the age or menopausal status and no differences in the levels of PD-L1 expression in type I and II of OC [ 32 ].…”

“…The impact of such clinical data as age, menopausal status, and BMI is not well established in the context of the PD-L1 expression in ovarian cancer. Interestingly, obesity has a paradoxical impact on cancer development [ 32 ]. It is well established that obesity inhibits the action of the immune system and is a risk factor for the development of many cancers, including ovarian cancer [ 33 , 34 ].…”

Endometriosis-Associated Massive Ascites in an Asian Woman: A Case Report of a Rare Clinical Entity

“…Although endometriosis has been implicated as a precursor for certain types of epithelial ovarian cancer [7,8], the occurrence of ascites secondary to endometriosis is rarely encountered, particularly among Asian women. This entity simulates gynecological malignancy and is seldom recognized before surgical exploration of the abdomen.…”

Semaphorin‑4C is upregulated in epithelial ovarian cancer

“…Epithelial ovarian cancer (EOC) is the main type of ovarian cancer and represents >90% cases. In addition, ~90% of patients dying from EOC suffer from type II EOC (3). Treatment for ovarian cancer usually includes a combination of surgery, radiation therapy and chemotherapy (4).…”