Invasive Stratified Mucin-producing Carcinoma of the Uterine Cervix: Comparison of Its Clinicopathological Characteristics and Programmed Death-ligand 1 Expression Status With Those of Other Endocervical Adenocarcinomas.

IF 1.6 4区 医学 Q4 ONCOLOGY Anticancer research Pub Date : 2024-11-01 DOI:10.21873/anticanres.17325
Jiyeon Lee, Sang Ah Chi, Sangjoon Choi, Hyun-Soo Kim
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Abstract

Background/aim: Invasive stratified mucin-producing carcinoma (ISMC) is a rare but aggressive variant of endocervical adenocarcinoma (EAC). The aim of this study was to investigate the differences in clinicopathological features, patient outcomes, and programmed death-ligand 1 (PD-L1) expression among ISMC, usual-type EAC (UEA), and gastric-type EAC (GEA).

Patients and methods: PD-L1 22C3 immunostaining was performed using 20 ISMCs, 20 UEAs, and 20 GEAs. Combined positive score (CPS) method was used to assess PD-L1 immunoreactivity.

Results: ISMC was diagnosed at a younger age and showed a more advanced stage and shorter survival than UEA. The disease-free survival (DFS) and overall survival (OS) rates of ISMC patients were lower than those of UEA but comparable to those of GEA. ISMC type was an independent prognostic factor for predicting short DFS [hazard ratio (HR)=2.790, 95% confidence interval (CI)=1.153-6.756] and OS (HR=6.071, 95%CI=1.257-29.327). All ISMCs showed PD-L1 over-expression with a mean CPS of 44.5 (range=10-100), which was higher than those of UEA (mean CPS=8.2) and GEA (mean CPS=6.5). PD-L1 positivity (CPS≥1) was also an independent prognostic factor for worse OS (HR=2.472, 95%CI=1.097-5.570). Despite PD-L1 over-expression, ISMC patients treated with pembrolizumab showed no clinical response.

Conclusion: All examined ISMCs over-expressed PD-L1. ISMC showed higher PD-L1 expression than UEA and GEA and worse survival than UEA. PD-L1 over-expression was found to be a significant predictor for worse DFS and OS in patients with ISMC. Our data suggest that PD-L1 over-expression is associated with poor ISMC prognosis.

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子宫颈浸润性分层粘液腺癌:其临床病理特征和程序性死亡配体 1 表达状况与其他宫颈内膜腺癌的比较。
背景/目的:浸润性分层粘液分泌癌(ISMC)是宫颈内膜腺癌(EAC)的一种罕见但具有侵袭性的变异型。本研究旨在探讨ISMC、普通型EAC(UEA)和胃型EAC(GEA)在临床病理特征、患者预后和程序性死亡配体1(PD-L1)表达方面的差异:用 20 个 ISMC、20 个 UEA 和 20 个 GEA 进行 PD-L1 22C3 免疫染色。采用联合阳性评分(CPS)法评估 PD-L1 免疫反应:结果:与 UEA 相比,ISMC 的确诊年龄更小、分期更晚、生存期更短。ISMC患者的无病生存率(DFS)和总生存率(OS)低于UEA,但与GEA相当。ISMC类型是预测较短DFS[危险比(HR)=2.790,95%置信区间(CI)=1.153-6.756]和OS(HR=6.071,95%CI=1.257-29.327)的独立预后因素。所有ISMC均显示PD-L1过度表达,平均CPS为44.5(范围=10-100),高于UEA(平均CPS=8.2)和GEA(平均CPS=6.5)。PD-L1阳性(CPS≥1)也是OS恶化的独立预后因素(HR=2.472,95%CI=1.097-5.570)。尽管PD-L1过度表达,但接受pembrolizumab治疗的ISMC患者没有出现临床反应:结论:所有受检的ISMC都过度表达了PD-L1。结论:所有受检的ISMC均过度表达PD-L1,ISMC的PD-L1表达高于UEA和GEA,存活率低于UEA。研究发现,PD-L1过度表达是导致ISMC患者DFS和OS恶化的重要预测因素。我们的数据表明,PD-L1过度表达与ISMC的不良预后有关。
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来源期刊
Anticancer research
Anticancer research 医学-肿瘤学
CiteScore
3.70
自引率
10.00%
发文量
566
审稿时长
2 months
期刊介绍: ANTICANCER RESEARCH is an independent international peer-reviewed journal devoted to the rapid publication of high quality original articles and reviews on all aspects of experimental and clinical oncology. Prompt evaluation of all submitted articles in confidence and rapid publication within 1-2 months of acceptance are guaranteed. ANTICANCER RESEARCH was established in 1981 and is published monthly (bimonthly until the end of 2008). Each annual volume contains twelve issues and index. Each issue may be divided into three parts (A: Reviews, B: Experimental studies, and C: Clinical and Epidemiological studies). Special issues, presenting the proceedings of meetings or groups of papers on topics of significant progress, will also be included in each volume. There is no limitation to the number of pages per issue.
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