Ashraf Ishak Fawzy Tawadros1, Mohamed Mohamed Mohamed Khalafalla2. 1. Department of Pathology, Faculty of Medicine, Minia University, Minia, Egypt. 2. Department of Obstetrics and Gynecology, Faculty of Medicine, Menoufia University, Al Menoufia, Egypt.
Abstract
BACKGROUND: Programmed death-ligand 1 (PD-L1) and hypoxia-inducible factor-1α (HIF-1α) proteins mediate major alterations of tumor microenvironment including generation of immunosuppressive microenvironment and tumor hypoxia, respectively. These alterations play a crucial role in carcinogenesis and tumor progression. AIMS: The present study was designed to investigate the correlation between the expression of PD-L1 and HIF-1α proteins and the clinicopathologic variables in endometrial carcinoma. MATERIALS AND METHODS: Tumor tissue sections from 95 endometrial carcinomas were evaluated for PD-L1 and HIF-1α immunohistochemical protein expression. STATISTICAL ANALYSIS USED: The statistical analyses were performed using Chi-square and Fisher's exact tests when appropriate. Two-sided P < 0.05 was considered statistically significant. RESULTS: PD-L1 and HIF-1α expression were detected in 48.4% and 68.4% of endometrial carcinomas, respectively. PD-L1 expression was significantly associated with lymph node metastasis (P = 0.027). HIF-1α expression was significantly associated with tumor grade, depth of myometrial invasion, and lymph node metastasis (P = 0.014, 0.012, and 0.046, respectively). A significant positive correlation was detected between PD-L1 and HIF-1α immunoexpression (P = 0.015). CONCLUSIONS: PD-L1 and HIF-1α proteins are promising potential prognostic biomarkers in endometrial carcinomas since their overexpression is associated with clinicopathologic variables of advanced disease. A potential role of HIF-1α in upregulation of PD-L1 expression is suggested based on the finding of positive correlation between PD-L1 and HIF-1α expression in endometrial carcinoma. These findings point to a potential role of biomarkers inhibitors in controlling endometrial cancer progression.
BACKGROUND: Programmed death-ligand 1 (PD-L1) and hypoxia-inducible factor-1α (HIF-1α) proteins mediate major alterations of tumor microenvironment including generation of immunosuppressive microenvironment and tumor hypoxia, respectively. These alterations play a crucial role in carcinogenesis and tumor progression. AIMS: The present study was designed to investigate the correlation between the expression of PD-L1 and HIF-1α proteins and the clinicopathologic variables in endometrial carcinoma. MATERIALS AND METHODS: Tumor tissue sections from 95 endometrial carcinomas were evaluated for PD-L1 and HIF-1α immunohistochemical protein expression. STATISTICAL ANALYSIS USED: The statistical analyses were performed using Chi-square and Fisher's exact tests when appropriate. Two-sided P < 0.05 was considered statistically significant. RESULTS: PD-L1 and HIF-1α expression were detected in 48.4% and 68.4% of endometrial carcinomas, respectively. PD-L1 expression was significantly associated with lymph node metastasis (P = 0.027). HIF-1α expression was significantly associated with tumor grade, depth of myometrial invasion, and lymph node metastasis (P = 0.014, 0.012, and 0.046, respectively). A significant positive correlation was detected between PD-L1 and HIF-1α immunoexpression (P = 0.015). CONCLUSIONS: PD-L1 and HIF-1α proteins are promising potential prognostic biomarkers in endometrial carcinomas since their overexpression is associated with clinicopathologic variables of advanced disease. A potential role of HIF-1α in upregulation of PD-L1 expression is suggested based on the finding of positive correlation between PD-L1 and HIF-1α expression in endometrial carcinoma. These findings point to a potential role of biomarkers inhibitors in controlling endometrial cancer progression.