Expression of programmed cell death Ligand 1 and mismatch repair status in ovarian carcinomas
Hariprasad, M. Rao, M. Elhence, P.A. Bharti, J.N. Singh, P. Yadav, G. Nalwa, A. Ramalingam, H. Goel, A. D.
Hariprasad, M.
Rao, M.
Elhence, P.A.
Bharti, J.N.
Singh, P.
Yadav, G.
Nalwa, A.
Ramalingam, H.
Goel, A. D.
Abstract
Background:
Ovarian carcinoma is the third most common gynecological malignancy among women in India, with a poor prognosis despite advancements in treatment modalities. Immunotherapy, particularly the use of programd cell death ligand 1 (PD-L1) checkpoint inhibitors, has emerged as a promising approach. This study investigates the relationship between PD-L1 expression, mismatch repair (MMR) status, and clinicopathological features in epithelial ovarian carcinoma (EOC).
Materials and Methods:
A cohort of 50 EOC cases was analyzed for PD-L1 expression in tumor cells and tumor-infiltrating lymphocytes (TILs) using immunohistochemistry (IHC). MMR status was also assessed through IHC. Statistical correlations between PD-L1 expression, MMR deficiency (dMMR), and clinicopathological parameters were evaluated.
Results:
PD-L1 expression in tumor cells and TILs was observed in 20% and 14% of cases, respectively. PD-L1 expression in tumor cells was absent in most advanced-stage tumors (stages III and IV) and cases with extraovarian spread. dMMR was identified in 30% (n = 15) of cases, predominantly in higher-stage tumors with extraovarian spread and significant TIL presence (P = 0.007). However, PD-L1 expression in tumor cells and TILs was absent in 86.7% and 80% of dMMR cases, respectively. No significant association was found between dMMR status and PD-L1 expression in EOC.
Conclusion:
PD-L1 expression in tumor cells is predominantly observed in early-stage EOC, suggesting its potential as a prognostic marker and therapeutic target. Although dMMR status correlates with advanced-stage disease and TIL presence, it does not significantly influence PD-L1 expression in EOC. These findings highlight the importance of routinely assessing PD-L1 and MMR status to guide immunotherapeutic strategies in ovarian carcinoma.
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Date
2025-07
Type
Article
Subject
Ovarian Neoplasms, Immunotherapy, Cell Death
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Citation
Hariprasad M, Rao M, Elhence PA, Bharti JN, Singh P, Yadav G, Nalwa A, Ramalingam H, Goel AD. Expression of Programmed Cell Death Ligand 1 and Mismatch Repair Status in Ovarian Carcinomas. J Midlife Health. 2025 Jul-Sep;16(3):309-314. doi: 10.4103/jmh.jmh_102_25. Epub 2025 Sep 5