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\nPD-L1 Immunohistochemical Expression in Endometrial Carcinoma: Egyptian Cross-Sectional Study  \nMaha Gamal Wahba1 *, Soliman Saba Soliman1, Maha Elsayed Salama1, Sara Sarah Nasr2, ZeinabAbd El-Azeem Elshreef1  \nAbstract  \nObjective: Endometrial carcinoma (EC) is the most common cancer of the female genital tract. According to the recently evolved strategies of cancer immunotherapy, immune checkpoints inhibitors are one of the most crucial strategies. Programmed Death Ligand 1 (PD-L1) is an important immune checkpoint regulator. PD-L1 antibodies have shown efficacy in clinical trials of some malignancies. Some of these antibodies have been approved for clinical usage by the Food and Drug Administration (FDA). Methods: This retrospective study included a total of 100 ECs, collected from archived, formalin-fixed, paraffin-embedded tissue blocks of hysterectomy specimens of Egyptian females. The samples were immunohistochemically analyzed for PD-L1 expression (in both tumor cells; TCs and tumor infiltrating leucocytes; TILs) by a semiquantitative score (0 to 4), with cutoff points of (0: \u003C1% of the cells, 1: 1% to 4%, 2: 5% to 9%, 3: 10% to 49%, and 4: ≥ 50%). Membranous staining only was considered positive. Results: PD-L1 was highly expressed in ECs (67% TCs+ and 61% TILs+), with statistically significant relationships with age, lympho-vascular space invasion (LVSI) and TILs score (P = 0.006, 0.016 and \u003C0.005 respectively) . However, no statistically significant relationships were detected between PD-L1 expression and the following parameters: histological type, histological grade, pathological stage (pT) or FIGO stage, myometrial, cervical, adnexal/serosal, parametrial involvements and nodal metastasis, as well as ESMO risk stratification system. Moreover, statistically significant relationships were achieved when correlating TILs score with tumor grade and LVSI (P = 0.034 and 0.012 respectively). Also, comparing endometrial hyperplasia (EH) PD-L1 and TCs PDL1 median scores achieved statistically significant relationship (P = 0.001) . Conclusion: Our results concluded that PD-L1 expression was greater in both TCs and TILs in a subgroup of patients that have advanced age, LVSI and are TILs-rich, identifying them as potential candidates for anti-PD-1/ PD-L1 immunotherapy.  \nKeywords: Endometrial carcinoma-PD-L1-immunohistochemistry-tumor cells-TILs  \nAsian Pac J Cancer Prev, 25 (4), 1441-1450  \nIntroduction  \nEC is the most common gynecologic cancer in the U.S. The incorporation of molecular testing using next-generation sequencing (targeted POLE sequencing) has been increasingly used in the last decades, in addition to the histopathological and immunohistochemical studies (with surrogate markers for all cases as MSH6, PMS2 and p53) to augment the diagnosis of EC and has been increasingly demanded by the oncologist for better targeted treatment and prognosis [1, 2]. But, unfortunately the health system in the developing countries doesn’t support these high-cost tests. In Egypt, EC accounts for 22.83% of all malignant female genital tract (FGT) tumors according to Cancer Pathology Registry, National Cancer Institute, Cairo University [3] and according to the Pathology-based Cancer Registry at the Ain-Shams  \nFaculty of Medicine, 31.4% of all malignant FGT tumors were ECs [4] .  \nCancer immunotherapy with checkpoint inhibitors has been changing the face of oncology treatments for several tumors, and EC may not be an exception [5] . Additional research is required to identify immune targets and patient type most likely to benefit from this treatment [6] .  \nThe programmed death (PD) 1 pathway is a major immune response checkpoint expressed by activated lymphocytes, having two known ligands, PD-L1 and PD-L2. PD-L1 appears tobe up-regulated in multiple solid malignancies [7], with demonstrated clinical responses by using anti-PDL1 monoclonal antibodies","cbCaiaSOGKmwI0lR","https://ap.wps.com/l/cbCaiaSOGKmwI0lR","pdf",3109554,"English","# Abstract\n# Introduction\n# Materials and Methods","[{\"question\":\"What was the study objective regarding PD-L1 in endometrial carcinoma?\",\"answer\":\"To evaluate PD-L1 immunohistochemical expression in endometrial carcinoma in both tumor cells and tumor-infiltrating leucocytes and correlate it with clinical and pathological parameters.\"},{\"question\":\"How were PD-L1 expression and positivity determined in the specimens?\",\"answer\":\"PD-L1 expression was scored semiquantitatively from 0 to 4, and only membranous staining was considered positive.\"},{\"question\":\"Which factors were significantly associated with PD-L1 expression in tumor cells and tumor-infiltrating leucocytes?\",\"answer\":\"PD-L1 expression was significantly associated with age, lympho-vascular space invasion (LVSI), and the TILs score, while several other clinical and pathological parameters showed no statistically significant relationships.\"}]","PD-L1 Immunohistochemical Expression in Endometrial Carcinoma - Egyptian Cross-Sectional Study | PDF",1790002408,25]