Dysgerminomas - germ cell tumors exhibit high expression of PD-L1 and associated with high TILs and good prognosis

Sep 21, 2026

Uploaded by Rowan

Ovarian germ cell tumors (OVGCTs) form a significant portion of ovarian cancers, yet recurrence leads to poor prognosis and more aggressive, chemoresistant disease. Limited evidence explains how immunotherapy targets these tumors, motivating an investigation of PD-L1 expression in OVGCTs and its relationship with tumor microenvironment cells and genetic alterations. Tumor tissue from 34 cases across multiple subtypes was profiled by immunohistochemistry for PD-L1, immune infiltration, and cancer stem cell populations, while TCGA datasets were analyzed via cBioPortal and GEPIA.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages14

Reading Time35 min

AccessFree to download

Study objectives

PD-L1 and immunological rationale

Materials and methods

Cohort and tumor subtypes

Immunohistochemistry and cell profiling

Public dataset analyses

Results and clinical significance

PD-L1 levels and TIL/stem markers

Genetic alterations and prognosis

[www. nature.com/scientificreports](www. nature.com/scientificreports) OPEN Dysgerminomas: germ cell tumors exhibit high expression of PD-L1 and associated with high TILs and good prognosis Kholoud Alwosaibai1􀀍, Zainab Ibrahim Alruwaii2, Miral Mashhour2, Fahad M. Almsned3,4, Reem Asraf5, Wadha Alrsheedy1, Ahmed Alessa1, Hani Almohanna3, Waleed Selwi6 & Faisal Azam6 Ovarian germ cell tumors (OVGCTs) account for 28% of all diagnosed ovarian cancers, and malignant germ cell tumors specifically account for approximately 13% of diagnosed ovarian cancers in Saudi Arabia. Although most germ cell tumor patients have a high survival rate, patients who experience tumor recurrence have a poor prognosis and present with more aggressive and chemoresistant tumors. The use of immunotherapeutic agents such as PD-L1/PD-1 inhibitors for OVGCTs remains very limited because few studies have described the immunological characteristics of these tumors. This study is the first to investigate PD-L1 expression in ovarian germ cell tumors and explore the role of PD-L1 expression in tumor microenvironment cells and genetic alterations. A total of 34 ovarian germ cell tumors were collected from pathology archives. The collected tumor tissues included ten dysgerminomas, five yolk sac tumors, five immature teratomas, and one mature teratoma, and the remaining samples were mixed germ cell tumors. The tumors were analyzed using immunohistochemical analysis to determine PD-L1 expression, immune cell infiltration and cancer stem cell populations and their correlation with clinical outcome. Furthermore, the genetic alterationsin different subtypes of germ cell tumors were correlated with PD-L1 expression and clinical outcome. Datasets for testicular germ cells (TGCTs) were retrieved from The Cancer Genome Atlas (TCGA) and analyzed using cBioPortal ([cbioportal.org](cbioportal.org)) and Gene Expression Profiling Interactive Analysis (GEPIA). Compared with yolk sac tumors, dysgerminomas highly express PD-L1 and are associated with high levels of tumor infiltrating lymphocytes (TILs) and stem cell markers. In addition, compared with PDL1-negative yolk sac tissue, dysgerminomas/seminomas with high PD-L1 expression are associated with more genetic alterations and a better prognosis. Our findings will contribute to the knowledge about the potential benefits of ovarian cancer immunotherapy in specific subsets of germ cell tumor patients and the risk factors for resistance mediated by tumor microenvironment cells. Ovarian cancer is one of the most common gynecological malignancies and has the third highest mortality rate after corpus uteri and cervical cancer1. In Saudi Arabia, ovarian cancer is the second most deadly gynecological malignancy in women2. Ovarian malignant neoplasms are pathologically classified as epithelial or nonepithelial in origin. Epithelial ovarian cancers comprise 92.3% of all malignant ovarian tumors. Subtypes of epithelial cells include high-grade serous, low-grade serous, mucinous, clear cell, and endometrioid ovarian carcinomas. Nonepithelial tumors comprise approximately 7% of all ovarian neoplasms, and these types are less well characterized. The two main subtypes of nonepithelial tumors are sex-cord stromal and ovarian germ cell tumors (OVGCTs). OVGCTs are rare ovarian tumors that develop from the primitive germ cells of embryonic gonads3. In contrast to females, in males, germ cell tumors are the most common type of cancer4.Therefore, several studies have investigated testicular germ cell tumors (TGCTs) . 1Biomedical Research Department, Research Center, King Fahad Specialist Hospital, Eastern Health Cluster, Dammam, Saudi Arabia. 2Department of Pathology and Lab Medicine, King Fahad Specialist Hospital, Eastern Health Cluster, Dammam, Saudi Arabia. 3Research Center, King Fahad Specialist Hospital, Eastern Health Cluster, Dammam, Saudi Arabia. 4School of Systems Biology, George Mason University, Fairfax, USA. 5School of Bi

FAQs

What was the main aim of this study on ovarian germ cell tumors?

To investigate PD-L1 expression in ovarian germ cell tumors and determine how PD-L1 relates to tumor microenvironment cells and genetic alterations.

How many ovarian germ cell tumor cases were analyzed, and which subtypes were included?

A total of 34 ovarian germ cell tumor cases were collected, including ten dysgerminomas, five yolk sac tumors, five immature teratomas, one mature teratoma, and additional mixed germ cell tumor samples.

What associations did the study find regarding dysgerminomas with high PD-L1?

Compared with other subtypes, dysgerminomas showed higher PD-L1 expression associated with higher tumor-infiltrating lymphocytes and stem cell markers, and high PD-L1 expression correlated with more genetic alterations and a better prognosis.

Sep 21, 2026

Uploaded by Rowan