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Introduction <p>Head and neck squamous cell carcinoma(SCC) is a major disease burden in developing nations like India, with high prevalence of smokable and oral tobacco use. A range of tissue and cellular alterations in the form of epithelial dysplasia commonly precedes squamous cell carcinoma. Programmed Cell Death Ligand 1 (PD-L1) is a transmembrane protein that is considered to be a co-inhibitory factor of the immune response. It can combine with PD-1 to reduce the proliferation of PD-1 positive cells, inhibit their cytokine secretion, and induce apoptosis. PD-L1 protein acts as a kind of “brake” to keep the body’s immune responses under control. Targeted immunotherapy in the form of immunomodulatory drugs has emerged aiming to restore the ability of the immune system to identify and destroy tumor cells in the treatment of head and neck SCC.</p> Materials and methods <p>Our study cohort consisted of 50 patients diagnosed with head and neck squamous cell carcinoma (HNSCC) and precursor squamous lesions with collated clinicopathological characteristics. The PD-L1 expression level was determined using the Combined positive score (CPS) in all samples using the PD-L1 IHC 22C3 pharmDx kit.</p> Results <p>There was heterogeneity in PD-L1 expression across different clinical stages of SCC. There was a wide range of CPS within each histological grade of SCC. In premalignant lesions, the CPS varied with the degree of dysplasia, with higher scores observed in high-grade dysplastic areas compared to low-grade dysplasia. Our study suggests that while PD-L1 is expressed in both malignant and premalignant lesions, its role as a standalone prognostic marker may be limited.</p> Conclusion <p>While the current study corroborates existing literature regarding high levels of PD-L1 expression in HNSCC and its potential role in precursor lesions, there is significant variability in prognostic implications. The lack of consistent correlation between PD-L1 levels and clinical outcomes suggests that additional biomarkers or comprehensive profiling may be necessary for more accurate predictions of treatment response.</p>

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PD-L1 Expression in Head and Neck Squamous Cell Carcinoma and Precursor Squamous Lesions: A Single-Center Study in South India

  • 期刊论文

  • 发表日期：

    2025年6月28日

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  • Gunvanti Rathod,
  • Anwesha Dutta Chawdhury,
  • Shrinivas Bheemrao Somalwar,
  • Immanuel Pradeep,
  • Namit Kant Singh

摘要

Introduction

Head and neck squamous cell carcinoma(SCC) is a major disease burden in developing nations like India, with high prevalence of smokable and oral tobacco use. A range of tissue and cellular alterations in the form of epithelial dysplasia commonly precedes squamous cell carcinoma. Programmed Cell Death Ligand 1 (PD-L1) is a transmembrane protein that is considered to be a co-inhibitory factor of the immune response. It can combine with PD-1 to reduce the proliferation of PD-1 positive cells, inhibit their cytokine secretion, and induce apoptosis. PD-L1 protein acts as a kind of “brake” to keep the body’s immune responses under control. Targeted immunotherapy in the form of immunomodulatory drugs has emerged aiming to restore the ability of the immune system to identify and destroy tumor cells in the treatment of head and neck SCC.

Materials and methods

Our study cohort consisted of 50 patients diagnosed with head and neck squamous cell carcinoma (HNSCC) and precursor squamous lesions with collated clinicopathological characteristics. The PD-L1 expression level was determined using the Combined positive score (CPS) in all samples using the PD-L1 IHC 22C3 pharmDx kit.

Results

There was heterogeneity in PD-L1 expression across different clinical stages of SCC. There was a wide range of CPS within each histological grade of SCC. In premalignant lesions, the CPS varied with the degree of dysplasia, with higher scores observed in high-grade dysplastic areas compared to low-grade dysplasia. Our study suggests that while PD-L1 is expressed in both malignant and premalignant lesions, its role as a standalone prognostic marker may be limited.

Conclusion

While the current study corroborates existing literature regarding high levels of PD-L1 expression in HNSCC and its potential role in precursor lesions, there is significant variability in prognostic implications. The lack of consistent correlation between PD-L1 levels and clinical outcomes suggests that additional biomarkers or comprehensive profiling may be necessary for more accurate predictions of treatment response.