Association of Programmed Death Ligand 1 and C-X-C Chemokine Receptor Type 4 Immunoexpression with Pelvic Lymph Node Metastasis in Cervical Squamous Cell Carcinoma

Abstract

BACKGROUND: Squamous cell carcinoma (SCC) is the most common type of cervical cancer. Pelvic lymph node metastasis in cervical SCC is common. Programmed death ligand 1 (PD-L1) on tumor cells has been reported to impede anti-tumor immunity, resulting in immune evasion. C-X-C chemokine receptor type 4 (CXCR4) plays an important role in proliferation, survival, and migration (chemotaxis) of tumor cells.
 AIM: This study aimed to analyze the association of PD-L1 and CXCR4 immunoexpression with pelvic lymph node metastasis in cervical SCC.
 MATERIALS AND METHODS: Forty cases of cervical SCC in the Department of Anatomical Pathology, Faculty of Medicine, Padjadjaran University, Dr. Hasan Sadikin Hospital, Bandung, during 2013–2018 were collected and divided into two groups; (1) cervical SCC metastasize to pelvic lymph node and (2) cervical SCC non-metastasize to pelvic lymph node, of 20 cases, respectively. The expression of PD-L1 and CXCR4 was detected using immunohistochemistry.
 RESULTS: High immunoexpression of PD-L1 and CXCR4 in cervical SCC showed significant association with pelvic lymph node metastasis (p < 0.05). The stepwise logistic regression analysis revealed that both PD-L1 and CXCR4 immunoexpression influenced pelvic lymph node metastasis simultaneously.
 CONCLUSION: It could be concluded that the higher PD-L1 and CXCR4 immunoexpression showed the higher ability of tumor cells to metastasize to the pelvic lymph node.