The Prognostic Values of HPV Genotypes and Tumor PD-L1 Expression in Patients With HPV-associated Endocervical Adenocarcinoma. (8th March 2022)

• Record Type: Journal Article
• Authors: Zhou, Feng; Chen, Hao; Li, Meiping; Strickland, Amanda L.; Zheng, Wenxin; Zhang, Xiaofei
• Is Part Of: American journal of surgical pathology. Volume 46:Number 3(2022)
• Page Start: 300
• Page End: 308
• Publication Date: 2022-03-08
• Subjects: HPV genotypes -- PD-L1 -- HPV-associated -- endocervical adenocarcinoma -- immune therapy; Pathology, Surgical -- Periodicals; 617.0705
• DOI: 10.1097/PAS.0000000000001800
• Languages: English
• ISSNs: 0147-5185

Abstract

Abstract : Despite the well-established pathogenic effect of high-risk human papillomavirus (hrHPV) genotypes on endocervical adenocarcinomas (ECAs), the prognostic values of hrHPV genotypes and their association with other prognostic variables have not been established. We categorized 120 usual-type human papillomavirus–associated (HPVA) ECA cases into 3 species groups (HPV16+, HPV18/45+, and other genotypes+) based on the hrHPV status. The clinical-stage, invasion patterns (Silva), and programmed death ligand-1 (PD-L1) expression were compared among genotype groups. In addition, log-rank test and Kaplan-Meier survival curves were used to compare progression-free survival (PFS) among different patient groups. A total of 120 ECA cases with positive hrHPV tests were included in this study. Among them, 51 (42.5%) were positive for HPV16, 50 (41.7%) were positive for HPV18 or 18/45, 9 (7.5%) were positive for other hrHPV genotypes (not including HPV16/18/45). Our data showed patients had no significant difference in clinical stages ( P =0.51), invasion patterns ( P =0.55), and PFS ( P =0.59) across genotype groups. Overall, a relatively high prevalence of PD-L1 expression was observed in HPVA ECAs (25% by tumor proportion score [TPS] and 55% by a combined positive score [CPS]). Using TPS, 19.6% (10/51) HPV16+ cases, 32.0% (16/50) cases of HPV18 or 18/45+ cases, and 22.2% (2/9) cases of other genotypes+ cases demonstrated PD-L1 positivity. No significant difference in PD-L1 expression was seen across genotype groups ( P =0.35). PD-L1 expression in tumors with patterns B and C was significantly higher than in those with pattern A ( P =0.00002). Patients with PD-L1-positive tumors by either CPS or TPS showed significantly poorer PFS than those with PD-L1-negative tumors (CPS, P =0.025; TPS, P =0.001). Our data support that HPV genotypes have no prognostic value in HPVA ECAs, while PD-L1 expression serves as a negative prognostic marker in HPVA ECAs and implies an unfavorable outcome.