Oral Kavite Skuamoz Hücreli Karsinom Hastalarında Pdl 1’i N Histopatolojik Korelasyonu ve Prognoza Etkisi

Abstract

Oral cavity malignancies are highly morbid and mortal, with more than 90% consisting of squamous cell carcinomas SCC). PD L1 protein, found on the membrane of tumor cells, binds to T lymphocytes and inactivates them. PD L1 expression has been shown to be associated with survival in many malignancies, especially malignant melanoma, colorectal carcinoma and lung cancer The aim of our study is to evaluate the relationship of PD L1 expression with patient characteristics and survival outcomes in oral cavity SCCs. For this purpose, adult patients diagnosed with oral cavity SCC who applied to Hacettepe University Faculty o f Medicine, Department of Otorhinolaryngology between 2014 and 2022 were included in the study. Baseline demographic and clinical data of the patients were examined retrospectively. Paraffin blocks containing the primary tumor and lymph node metastases in the pathology archive were evaluated by immunohistochemistry for PD L1 expression, and tumor proportion score ( and combined positive score ( were obtained. Possible relationships between TPS and CPS and patient characteristics and survival outcome s were investigated using statistical methods. The mean age of a total of 96 patients included in the study ( male and 38.5% female) was 58.758.7±15.5 years. The frequency of CPS 20% in patients diagnosed with lower lip SCC was found to be significantly higher compared to other localizations ( vs. 60.3%, p 0.015). Similarly, TPS positivity was associated with lower lip involvement 1%, p=0.014; 20%, p<0.001). In univariate analyses, tongue or lower lip involvement, stage III IV disease or ECOG PS 2 at diagnosis, receiving chemotherapy or radiotherapy, and 20% TPS in the primary tumor tissue were associated with progression free survival ( The multivariate regression model showed that ECOG PS 2 was an independent factor determining the r isk of progression ( 2.206, 95% CI: 1.153 4.219, p=0.017). When the model was applied to 37 patients who had not received chemotherapy or radiotherapy, ECOG PS 2 ( 26.39, 95% CI: 4.089 170.4, p<0.001), stage III IV disease at diagnosis ( 10.57, 9 5% CI: 1.874 59.66, p=0.008) and 20% TPS in primary tumor tissue ( 0.125, 95% CI: 0.026 0.594, p=0.009) were determined as independent risk factors for PFS. In conclusion, our study revealed that increased tumoral PD L1 expression is an independent fa ctor that reduces the risk of progression in early stage patients who have not received chemotherapy or radiotherapy. Key