The Expression of Programmed Cell Death Ligand-1 and its Relationship with Infiltration, Metastasis and Prognosis in Cervical Squamous Cell Carcinoma.

Abstract

Cervical cancer (CC) represents a major gynecologic health problem. Respecting the role of programmed cell death ligand-1 (PDL-1) in cancer prognosis, we investigated its relationship with cervical squamous cell carcinoma (CSCC) invasion, metastasis and prognosis. A total of 184 CSCC patients were retrospectively selected, with normal paracarcinoma tissues as the Control group. PDL-1 expression was assessed, and its relationship with CSCC prognosis and clinical value on predicting CSCC invasion/metastasis and poor prognosis were determined. PDL-1 was up-regulated in CSCC. CSCC patients at International Federation of Gynecology and Obstetrics stage II/III, and with lymph node metastasis (LNM), parauterine/vascular infiltration, and history of sexually transmitted diseases exhibited up-regulated PDL-1. The areas under the curve of PDL-1 on predicting the invasion and metastasis/poor prognosis of CSCC patients were 0.930 (95%Cl: 0.883-0.962)/0.935 (95%Cl: 0.886-0.967), with cut-off values of 23.27/24.86 (86.76%/80.95% sensitivity, 95.69%/92.68% specificity). The CSCC patients with highly-expressed PDL-1 showed increased cumulative incidence of poor prognosis. Additionally, occurence of vascular infiltration/LNM, and up-regulated PDL-1 were independent risk factors for poor prognosis in CSCC patients. Briefly, PDL-1 expression rised in CSCC. High PDL-1 expression might promote tumor infiltration and LNM, while close monitoring of its expression contributed to evaluating prognosis of CSCC patients.