Abstract
The programme death ligand1 and its receptor (PD-1/PD-L1) interaction is a target for blockage by immunotherapy that uses the body's own immune system. Some studies show that PD-L1 expressing tumours are also more aggressive with poor prognosis. This study evaluated the immunohistochemical expression of PD-L1 in uterine cervical carcinomas. Women with cervical cancer would benefit from its use as a marker in therapy and prognosis. Hospital-based cross-sectional retrospective study was conducted. The study materials included 183 archived formalin fixed and paraffin embedded (FFPE) tissue blocks with histological diagnosis of cervical carcinoma diagnosed in our facility within a five-year period (January 2012 and December 2016) that met the study criteria. Data were extracted from records in the Department and immunohistochemistry was done using polyclonal antibodies to PD-L1 (GTX104763, Genetex). Obtained data were analysed using SPSS version 23. P < 0.05 was considered significant. A hundred and eighty-three cases of cervical cancer were studied. PD-L1 was positive in 57.4% of all cases. The diffuse pattern of staining was the major pattern accounting for 88.5% of positive cases. Poorly differentiated cervical carcinomas are less likely to express PD-L1. Within the histologic types, the squamous cell carcinomas expressed PD-L1 in 58.7%, and 50% of adenocarcinomas were positive. PD-L1 was not expressed in all cases of adenoid cystic carcinomas and basaloid squamous cell carcinomas. A significant population of cervical carcinoma expresses PD-L1 by immunohistochemistry. PD-L1 prevalence is lower amongst the poorly differentiated cancers compared to other grades.
Highlights
Uterine cervical carcinoma is the fourth most common cancer amongst women worldwide and the most common gynaecological cancer in sub-Saharan African [1,2,3]
This study evaluated the immunohistochemical expression of PD-L1 in uterine cervical carcinomas
Cervical cancer is caused by persistent infection with high risk Human Papilloma Virus (HPV) with types 16 and 18 accounting for more than 70% of invasive cervical carcinomas and types 16, 18, 35 and 45 being the commonest amongst sub-Saharan Africans [4,5,6]
Summary
Uterine cervical carcinoma is the fourth most common cancer amongst women worldwide and the most common gynaecological cancer in sub-Saharan African [1,2,3]. Cervical squamous cell carcinomas are graded using the Broder’s classification into well differentiated (grade 1), moderately differentiated (grade 2) and poorly differentiated (grade 3), while cervical adenocarcinomas are graded based on architectural features [7]. This stratification of cervical carcinomas have not provided consistent prognosis or predicted response to therapy [8]. The body has a natural protective mechanism against cancer by recognizing such malignant cells as foreign and attacking and destroying them a process which can auto-propagate as the cancer immunity cycle. Women with cervical cancer would benefit from its use as a marker in therapy and prognosis
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