{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T23:18:53Z","timestamp":1783207133012,"version":"3.54.6"},"reference-count":59,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T00:00:00Z","timestamp":1783123200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T00:00:00Z","timestamp":1783123200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100009367","name":"Mansoura University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100009367","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Oral Squamous Cell Carcinoma (OSCC) is considered a highly immunosuppressive malignancy largely mediated by the Programmed Cell Death 1\/Programmed Cell Death Ligand 1(PD-1\/PD-L1) axis. The interaction between PD-L1 expressed on tumor cells and PD-1 receptors on T-cells results in T-cell dysfunction, exhaustion, and immune evasion within the tumor microenvironment. This study aimed to evaluate PD-L1 expression in primary non-metastatic OSCC, primary metastatic OSCC, and nodal metastatic OSCC, as well as to investigate its association with different available clinicopathological parameters. Immunohistochemical staining was performed to retrospectively evaluate PD-L1 expression in 30 archival paraffin-embedded OSCC specimens retrieved from the Department of Oral Pathology, Faculty of Dentistry, and the Oncology Center, Faculty of Medicine, Mansoura University. PD-L1 immunoreactivity was evaluated using a semi-quantitative scoring system based on both the staining intensity and the percentage of positively stained cells. The percentage of immunopositive cells was scored as stated: 0 (0%); 1 (&lt;\u200925%); 2 (25\u201350%); 3 (50\u201375%); and 4 (&gt;\u200975%). Staining intensity was graded as follows: (0\u2009=\u2009negative); (1\u2009=\u2009weak); (2\u2009=\u2009moderate); and (3\u2009=\u2009strong). A combined immunoreactivity score was calculated by adding the percentage and the intensity for each case (range 0\u20137). The final score was categorized as follows: 0 (negative); 1\u20133 (weak); 4\u20137 (strong). Statistical analysis was conducted to determine significant differences and correlations between PD-L1 expression and clinicopathological parameters using the Chi-square test, Monte Carlo test, one-way ANOVA, Student\u2019s t-test, and Fisher\u2019s exact test. The p-value\u2009&lt;\u20090.05 was considered statistically significant. PD-L1 immunopositivity was detected in all OSCC cases (100%). A statistically significant difference was observed among the different studied groups (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001), with the strongest PD-L1 expression detected in both primary metastatic and nodal metastatic OSCC. Strong PD-L1 expression showed a significant association with patient age (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.024). Additionally, a significant correlation was identified between PD-L1 expression and the depth of tumor invasion (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001). PD-L1 expression may have a potential role in tumor progression of OSCC.\n                  <\/jats:p>","DOI":"10.1038\/s41598-026-60283-6","type":"journal-article","created":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T21:34:31Z","timestamp":1783200871000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Programmed cell death ligand 1(PD-L1) association in metastatic and non-metastatic oral squamous cell carcinoma: clinicopathologic and immunohistochemical study"],"prefix":"10.1038","volume":"16","author":[{"given":"Eman M.","family":"Kamel","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9054-8333","authenticated-orcid":false,"given":"Doaa A. M.","family":"Esmaeil","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramy A.","family":"Abdelsalam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Azza A.","family":"El-Sisi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,4]]},"reference":[{"issue":"1","key":"60283_CR1","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1038\/s41368-023-00249-w","volume":"15","author":"Y Tan","year":"2023","unstructured":"Tan, Y. et al. Oral squamous cell carcinomas: state of the field and emerging directions. Int. J. Oral Sci. 15 (1), 44 (2023).","journal-title":"Int. J. Oral Sci."},{"issue":"3","key":"60283_CR2","first-page":"209","volume":"71","author":"H Sung","year":"2021","unstructured":"Sung, H. et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J. Clin. 71 (3), 209\u2013249 (2021).","journal-title":"CA Cancer J. Clin."},{"issue":"2","key":"60283_CR3","first-page":"126","volume":"134","author":"M Bankvall","year":"2024","unstructured":"Bankvall, M. et al. Common oral mucosal lesions. Den Nor. Tann Tid. 134 (2), 126\u2013138 (2024).","journal-title":"Den Nor. Tann Tid"},{"key":"60283_CR4","doi-asserted-by":"publisher","first-page":"155489","DOI":"10.1016\/j.prp.2024.155489","volume":"261","author":"D Jagadeesan","year":"2024","unstructured":"Jagadeesan, D. et al. Comprehensive insights into oral squamous cell carcinoma: diagnosis, pathogenesis, and therapeutic advances. Pathol. Pract. 261, 155489 (2024).","journal-title":"Pathol. Pract."},{"issue":"2","key":"60283_CR5","doi-asserted-by":"publisher","first-page":"475","DOI":"10.7150\/ijbs.55716","volume":"17","author":"Z Peng","year":"2021","unstructured":"Peng, Z. et al. Application of radiomics and machine learning in head and neck cancers. Int. J. Biol. Sci. 17 (2), 475 (2021).","journal-title":"Int. J. Biol. Sci."},{"issue":"8","key":"60283_CR6","first-page":"3650","volume":"13","author":"MK Puttaraju","year":"2023","unstructured":"Puttaraju, M. K. & Nitin, P. Conceptual model for progression of oral cancer-our perspective. Am. J. Cancer Res. 13 (8), 3650 (2023).","journal-title":"Am. J. Cancer Res."},{"issue":"4","key":"60283_CR7","doi-asserted-by":"publisher","first-page":"803","DOI":"10.1111\/odi.13608","volume":"27","author":"CS Farah","year":"2021","unstructured":"Farah, C. S. Molecular, genomic and mutational landscape of oral leukoplakia. Oral Dis. 27 (4), 803\u2013812 (2021).","journal-title":"Oral Dis."},{"issue":"1","key":"60283_CR8","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1038\/s41598-020-66257-6","volume":"10","author":"K Dave","year":"2020","unstructured":"Dave, K., Ali, A. & Magalhaes, M. Increased expression of PD-1 and PD-L1 in oral lesions progressing to oral squamous cell carcinoma: A pilot study. Sci. Rep. 10 (1), 1\u201311 (2020).","journal-title":"Sci. Rep."},{"key":"60283_CR9","doi-asserted-by":"crossref","unstructured":"Caruntu A, Scheau C, Tampa M, Georgescu SR, Caruntu C, Tanase C. Complex Interaction among immune, inflammatory, and carcinogenic mechanisms in the head and neck squamous cell carcinoma. In: Best Practice in Health Care. Springer; 2021. p. 11\u201335.","DOI":"10.1007\/5584_2021_626"},{"issue":"11","key":"60283_CR10","doi-asserted-by":"publisher","first-page":"651","DOI":"10.1038\/s41577-020-0306-5","volume":"20","author":"AD Waldman","year":"2020","unstructured":"Waldman, A. D., Fritz, J. M. & Lenardo, M. J. A guide to cancer immunotherapy: from T cell basic science to clinical practice. Nat. Rev. Immunol. 20 (11), 651\u2013668 (2020).","journal-title":"Nat. Rev. Immunol."},{"key":"60283_CR11","doi-asserted-by":"publisher","first-page":"1132","DOI":"10.1007\/s10637-021-01082-w","volume":"39","author":"A Gao","year":"2021","unstructured":"Gao, A., Pan, X., Yang, X. & Lin, Z. Predictive factors in the treatment of oral squamous cell carcinoma using PD-1\/PD-L1 inhibitors. Invest. New. Drugs. 39, 1132\u20131138 (2021).","journal-title":"Invest. New. Drugs"},{"issue":"5","key":"60283_CR12","doi-asserted-by":"publisher","first-page":"353","DOI":"10.1038\/s41577-024-01111-8","volume":"25","author":"M Roerden","year":"2025","unstructured":"Roerden, M. & Spranger, S. Cancer immune evasion, immunoediting and intratumour heterogeneity. Nat. Rev. Immunol. 25 (5), 353\u2013369 (2025).","journal-title":"Nat. Rev. Immunol."},{"key":"60283_CR13","doi-asserted-by":"publisher","first-page":"1679934","DOI":"10.3389\/fimmu.2025.1679934","volume":"16","author":"R Mahamed","year":"2025","unstructured":"Mahamed, R., Monchusi, B., Penny, C. & Mirza, S. Cancer-derived exosomes: mediators of immune crosstalk and emerging targets for immunotherapy. Front. Immunol. 16, 1679934 (2025).","journal-title":"Front. Immunol."},{"issue":"1\u20132","key":"60283_CR14","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3233\/ISB-200475","volume":"14","author":"F Tavakoli","year":"2021","unstructured":"Tavakoli, F., Sartakhti, J. S., Manshaei, M. H. & Basanta, D. Cancer immunoediting: A game theoretical approach. Silico Biol. 14 (1\u20132), 1\u201312 (2021).","journal-title":"Silico Biol."},{"key":"60283_CR15","doi-asserted-by":"publisher","first-page":"964442","DOI":"10.3389\/fimmu.2022.964442","volume":"13","author":"Q Tang","year":"2022","unstructured":"Tang, Q. et al. The role of PD-1\/PD-L1 and application of immune-checkpoint inhibitors in human cancers. Front. Immunol. 13, 964442 (2022).","journal-title":"Front. Immunol."},{"key":"60283_CR16","doi-asserted-by":"crossref","unstructured":"Ai, L., Xu, A. & Xu, J. Roles of PD-1\/PD-L1 pathway: signaling, cancer, and beyond. Regul. Cancer Immune Checkpoints Mol. Cell. Mech. Ther. ;33\u201359. (2020).","DOI":"10.1007\/978-981-15-3266-5_3"},{"issue":"1","key":"60283_CR17","doi-asserted-by":"publisher","first-page":"108","DOI":"10.1186\/s12943-024-02023-w","volume":"23","author":"X Lin","year":"2024","unstructured":"Lin, X. et al. Regulatory mechanisms of PD-1\/PD-L1 in cancers. Mol. Cancer. 23 (1), 108 (2024).","journal-title":"Mol. Cancer"},{"key":"60283_CR18","doi-asserted-by":"publisher","first-page":"931647","DOI":"10.3389\/fendo.2022.931647","volume":"13","author":"S Banerjee","year":"2022","unstructured":"Banerjee, S. et al. Role of cytotoxic T cells and PD-1 immune checkpoint pathway in papillary thyroid carcinoma. Front. Endocrinol. (Lausanne). 13, 931647 (2022).","journal-title":"Front. Endocrinol. (Lausanne)"},{"issue":"12","key":"60283_CR19","doi-asserted-by":"publisher","first-page":"411","DOI":"10.1007\/s13205-023-03826-2","volume":"13","author":"S Singh","year":"2023","unstructured":"Singh, S. et al. Understanding immune checkpoints and PD-1\/PD-L1-mediated immune resistance towards tumour immunotherapy. 3 Biotech. 13 (12), 411 (2023).","journal-title":"3 Biotech."},{"key":"60283_CR20","unstructured":"Han, Y., Liu, D., Li, L. & PD-1 \/PD-L1 pathway: current researches in cancer [Internet]. Vol. 10, American journal of cancer research. Pathology Department of Dalian Medical University Liaoning 116044, China.; pp. 727\u201342. Available from: http:\/\/europepmc.org\/abstract\/MED\/32266087 (2020)."},{"issue":"3","key":"60283_CR21","doi-asserted-by":"publisher","first-page":"213","DOI":"10.1080\/15321819.2022.2137810","volume":"44","author":"DO Helmy","year":"2023","unstructured":"Helmy, D. O., Khattab, F., Hegazy, A. E. & Sabry, R. M. Immunohistochemical expression of immune check point protein PDL-1 in hepatocellular carcinoma denotes its prognostic significance and association with survival. J. Immunoass. Immunochem. 44 (3), 213\u2013228 (2023).","journal-title":"J. Immunoass. Immunochem"},{"issue":"2","key":"60283_CR22","doi-asserted-by":"publisher","first-page":"173","DOI":"10.1111\/odi.13509","volume":"27","author":"D Lenouvel","year":"2021","unstructured":"Lenouvel, D. et al. Clinicopathological and prognostic significance of PD\u2010L1 in oral cancer: A preliminary retrospective immunohistochemistry study. Oral Dis. 27 (2), 173\u2013182 (2021).","journal-title":"Oral Dis."},{"issue":"3","key":"60283_CR23","doi-asserted-by":"publisher","first-page":"1124","DOI":"10.1002\/cam4.1929","volume":"8","author":"M Weber","year":"2019","unstructured":"Weber, M. et al. Prognostic significance of PD\u2010L2 expression in patients with oral squamous cell carcinoma\u2014A comparison to the PD\u2010L1 expression profile. Cancer Med. 8 (3), 1124\u20131134 (2019).","journal-title":"Cancer Med."},{"issue":"1","key":"60283_CR24","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1007\/s12105-021-01402-9","volume":"16","author":"S Muller","year":"2022","unstructured":"Muller, S. & Tilakaratne, W. M. Update from the 5th edition of the World Health Organization classification of head and neck tumors: tumours of the oral cavity and mobile tongue. Head Neck Pathol. 16 (1), 54\u201362 (2022).","journal-title":"Head Neck Pathol."},{"issue":"4","key":"60283_CR25","doi-asserted-by":"publisher","first-page":"398","DOI":"10.1177\/1724600819884722","volume":"34","author":"SW Chen","year":"2019","unstructured":"Chen, S. W. et al. Expression of PD-1\/PD-L1 in head and neck squamous cell carcinoma and its clinical significance. Int. J. Biol. Markers. 34 (4), 398\u2013405 (2019).","journal-title":"Int. J. Biol. Markers"},{"issue":"7","key":"60283_CR26","doi-asserted-by":"publisher","first-page":"836","DOI":"10.1016\/j.ijom.2018.01.004","volume":"47","author":"Y Maruse","year":"2018","unstructured":"Maruse, Y. et al. Significant association of increased PD-L1 and PD-1 expression with nodal metastasis and a poor prognosis in oral squamous cell carcinoma. Int. J. Oral Maxillofac. Surg. 47 (7), 836\u2013845 (2018).","journal-title":"Int. J. Oral Maxillofac. Surg."},{"issue":"5","key":"60283_CR27","doi-asserted-by":"publisher","first-page":"e0269136","DOI":"10.1371\/journal.pone.0269136","volume":"17","author":"S Blatt","year":"2022","unstructured":"Blatt, S. et al. Differences in PD-L1 Expression between oral and oropharyngeal squamous cell carcinoma. PLoS One. 17 (5), e0269136 (2022).","journal-title":"PLoS One"},{"issue":"2","key":"60283_CR28","doi-asserted-by":"publisher","first-page":"238","DOI":"10.3390\/life12020238","volume":"12","author":"DH Geum","year":"2022","unstructured":"Geum, D. H. et al. PD-L1 expression correlated with clinicopathological factors and Akt\/Stat3 pathway in oral SCC. Life 12 (2), 238 (2022).","journal-title":"Life"},{"issue":"10","key":"60283_CR29","doi-asserted-by":"publisher","first-page":"3471","DOI":"10.31557\/APJCP.2024.25.10.3471","volume":"25","author":"HS Wahbi","year":"2024","unstructured":"Wahbi, H. S. & Al Manadili, A. The expression of PDL-1 and PD1 in the microenvironment of oral squamous cell carcinoma. Asian Pac. J. cancer Prev. APJCP. 25 (10), 3471 (2024).","journal-title":"Asian Pac. J. cancer Prev. APJCP"},{"key":"60283_CR30","unstructured":"Mneimneh, W. S. et al. Clinicopathologic characteristics of young patients with oral squamous cell carcinoma. Head Neck Pathol. ;1\u201310. (2021)."},{"issue":"12","key":"60283_CR31","doi-asserted-by":"publisher","first-page":"4039","DOI":"10.31557\/APJCP.2022.23.12.4039","volume":"23","author":"S Saeed","year":"2022","unstructured":"Saeed, S. et al. Comparison of PD-L1 Expression in Oral Squamous Cell Carcinoma and Premalignant Lesions of Oral Cavity. Asian Pac. J. Cancer Prev. APJCP. 23 (12), 4039 (2022).","journal-title":"Asian Pac. J. Cancer Prev. APJCP"},{"issue":"3","key":"60283_CR32","doi-asserted-by":"publisher","first-page":"177","DOI":"10.24171\/j.phrp.2019.10.3.09","volume":"10","author":"MMF Elmetwaly","year":"2019","unstructured":"Elmetwaly, M. M. F. et al. Morbidity Profile of Cases Attended Oncology Center of Mansoura University (OCMU), Egypt: A Cross-Sectional Study. Osong Public. Heal Res. Perspect. 10 (3), 177 (2019).","journal-title":"Osong Public. Heal Res. Perspect."},{"issue":"1","key":"60283_CR33","doi-asserted-by":"publisher","first-page":"141","DOI":"10.1002\/cre2.523","volume":"8","author":"S Wolfer","year":"2022","unstructured":"Wolfer, S. et al. Gender and risk\u2010taking behaviors influence the clinical presentation of oral squamous cell carcinoma. Clin. Exp. Dent. Res. 8 (1), 141\u2013151 (2022).","journal-title":"Clin. Exp. Dent. Res."},{"issue":"1","key":"60283_CR34","doi-asserted-by":"publisher","first-page":"21698","DOI":"10.1038\/s41598-023-48572-w","volume":"13","author":"LR Greeshma","year":"2023","unstructured":"Greeshma, L. R., Joseph, A. P., Sivakumar, T. T., Raghavan Pillai, V. & Vijayakumar, G. Correlation of PD-1 and PD-L1 expression in oral leukoplakia and oral squamous cell carcinoma: an immunohistochemical study. Sci. Rep. 13 (1), 21698 (2023).","journal-title":"Sci. Rep."},{"issue":"7","key":"60283_CR35","doi-asserted-by":"publisher","first-page":"1061","DOI":"10.1136\/jim-2018-000968","volume":"67","author":"SH Tealab","year":"2019","unstructured":"Tealab, S. H., Sedhom, N. F. H., Hassouna, A., Gouda, I. & Ismail, H. Prevalence of human papilloma virus in oropharyngeal, tongue and lip squamous cell carcinoma: an experience from the Egyptian National Cancer Institute. J. Investig Med. 67 (7), 1061\u20131066 (2019).","journal-title":"J. Investig Med."},{"issue":"1","key":"60283_CR36","doi-asserted-by":"publisher","first-page":"141","DOI":"10.1186\/s12903-024-03869-8","volume":"24","author":"A Janovi\u0107","year":"2024","unstructured":"Janovi\u0107, A., Bracanovi\u0107, \u0110., Anti\u0107, S. & Markovi\u0107-Vasiljkovi\u0107, B. Demographic and imaging features of oral squamous cell cancer in Serbia: a retrospective cross-sectional study. BMC Oral Health. 24 (1), 141 (2024).","journal-title":"BMC Oral Health"},{"key":"60283_CR37","doi-asserted-by":"crossref","unstructured":"Lee, Y. C. et al. Characteristics and outcome differences in male and female oral cavity cancer patients in Taiwan. Med. (Baltim). ;100(44). (2021).","DOI":"10.1097\/MD.0000000000027674"},{"issue":"3","key":"60283_CR38","doi-asserted-by":"publisher","first-page":"e274","DOI":"10.4317\/medoral.25147","volume":"27","author":"BVR Louredo","year":"2022","unstructured":"Louredo, B. V. R. et al. Epidemiology and survival outcomes of lip, oral cavity, and oropharyngeal squamous cell carcinoma in a southeast Brazilian population. Med. Oral Patol. Oral Cir. Bucal. 27 (3), e274 (2022).","journal-title":"Med. Oral Patol. Oral Cir. Bucal"},{"issue":"2","key":"60283_CR39","doi-asserted-by":"publisher","first-page":"125","DOI":"10.1016\/j.jobcr.2021.01.004","volume":"11","author":"SM Gondivkar","year":"2021","unstructured":"Gondivkar, S. M. et al. Oral and general health-related quality of life in oral squamous cell carcinoma patients-comparative analysis of different treatment regims. J. Oral Biol. Craniofac. Res. 11 (2), 125\u2013131 (2021).","journal-title":"J. Oral Biol. Craniofac. Res."},{"issue":"7","key":"60283_CR40","doi-asserted-by":"publisher","first-page":"1806","DOI":"10.1111\/odi.13701","volume":"27","author":"SN Khawaja","year":"2021","unstructured":"Khawaja, S. N., Jamshed, A. & Hussain, R. T. Prevalence of pain in oral cancer: A retrospective study. Oral Dis. 27 (7), 1806\u20131812 (2021).","journal-title":"Oral Dis."},{"issue":"1","key":"60283_CR41","first-page":"2578271","volume":"2024","author":"D Albano","year":"2024","unstructured":"Albano, D. et al. Oral Squamous Cell Carcinoma: Features and Medico-Legal Implications of Diagnostic Omission. Case Rep. Dent. 2024 (1), 2578271 (2024).","journal-title":"Case Rep. Dent."},{"issue":"1","key":"60283_CR42","doi-asserted-by":"publisher","first-page":"305","DOI":"10.1186\/s12903-022-02336-6","volume":"22","author":"MM Yasin","year":"2022","unstructured":"Yasin, M. M., Abbas, Z. & Hafeez, A. Correlation of histopathological patterns of OSCC patients with tumor site and habits. BMC Oral Health. 22 (1), 305 (2022).","journal-title":"BMC Oral Health"},{"key":"60283_CR43","doi-asserted-by":"crossref","unstructured":"Chen, J., Zou, D., Zan, H., Li, X. & Kim, H. J. Evaluating differentiation grade as a guide for decision-making in elective neck dissection for early-stage oral squamous cell carcinoma: a population-based cohort study. Transl Cancer Res. ;15(1). (2026).","DOI":"10.21037\/tcr-2025-1593"},{"key":"60283_CR44","doi-asserted-by":"crossref","unstructured":"Fatima, J. et al. Comprehensive analysis of oral squamous cell carcinomas: clinical, epidemiological, and histopathological insights with a focus on prognostic factors and survival time. Cureus ;16(2). (2024).","DOI":"10.7759\/cureus.54394"},{"key":"60283_CR45","doi-asserted-by":"publisher","first-page":"1003228","DOI":"10.37349\/ei.2025.1003228","volume":"5","author":"N Kannan","year":"2025","unstructured":"Kannan, N. et al. Immune evasion mechanisms and cutting-edge therapeutic strategies of PD-L1 pathway in oral squamous cell carcinoma: an umbrella review. Explor. Immunol. 5, 1003228 (2025).","journal-title":"Explor. Immunol."},{"issue":"11","key":"60283_CR46","doi-asserted-by":"publisher","first-page":"1456","DOI":"10.1002\/cac2.70064","volume":"45","author":"J Hu","year":"2025","unstructured":"Hu, J., Li, Y., Lian, B., Mao, Y. & Zhao, L. Mechanism and role of regulated cell death in tumor immunity and immunotherapy. Cancer Commun. 45 (11), 1456\u20131495 (2025).","journal-title":"Cancer Commun."},{"key":"60283_CR47","doi-asserted-by":"publisher","first-page":"1226038","DOI":"10.3389\/fimmu.2023.1226038","volume":"14","author":"YC Zhang","year":"2023","unstructured":"Zhang, Y. C., Zhang, Y. T., Wang, Y., Zhao, Y. & He, L. J. What role does PDL1 play in EMT changes in tumors and fibrosis? Front. Immunol. 14, 1226038 (2023).","journal-title":"Front. Immunol."},{"issue":"7","key":"60283_CR48","doi-asserted-by":"publisher","first-page":"529","DOI":"10.1038\/s41573-022-00493-5","volume":"21","author":"TK Kim","year":"2022","unstructured":"Kim, T. K., Vandsemb, E. N., Herbst, R. S. & Chen, L. Adaptive immune resistance at the tumour site: mechanisms and therapeutic opportunities. Nat. Rev. Drug Discov. 21 (7), 529\u2013540 (2022).","journal-title":"Nat. Rev. Drug Discov"},{"issue":"10","key":"60283_CR49","doi-asserted-by":"publisher","first-page":"e003623","DOI":"10.1136\/jitc-2021-003623","volume":"9","author":"AM Heeren","year":"2021","unstructured":"Heeren, A. M. et al. Immune landscape in vulvar cancer-draining lymph nodes indicates distinct immune escape mechanisms in support of metastatic spread and growth. J. Immunother Cancer. 9 (10), e003623 (2021).","journal-title":"J. Immunother Cancer"},{"issue":"2","key":"60283_CR50","doi-asserted-by":"publisher","first-page":"259","DOI":"10.1016\/j.suronc.2018.04.007","volume":"27","author":"S Okada","year":"2018","unstructured":"Okada, S. et al. Significance of PD-L1 expression in pulmonary metastases from head and neck squamous cell carcinoma. Surg. Oncol. 27 (2), 259\u2013265 (2018).","journal-title":"Surg. Oncol."},{"issue":"3","key":"60283_CR51","doi-asserted-by":"publisher","first-page":"546","DOI":"10.1158\/1055-9965.EPI-18-0779","volume":"28","author":"JC de Vicente","year":"2019","unstructured":"de Vicente, J. C. et al. PD-L1 expression in tumor cells is an independent unfavorable prognostic factor in oral squamous cell carcinoma. Cancer Epidemiol. Biomarkers Prev. 28 (3), 546\u2013554 (2019).","journal-title":"Cancer Epidemiol. Biomarkers Prev."},{"key":"60283_CR52","doi-asserted-by":"publisher","first-page":"1296341","DOI":"10.3389\/fimmu.2023.1296341","volume":"14","author":"A Parvez","year":"2023","unstructured":"Parvez, A. et al. PD-1 and PD-L1: architects of immune symphony and immunotherapy breakthroughs in cancer treatment. Front. Immunol. 14, 1296341 (2023).","journal-title":"Front. Immunol."},{"issue":"17","key":"60283_CR53","doi-asserted-by":"publisher","first-page":"2805","DOI":"10.3390\/cancers17172805","volume":"17","author":"P Kawczak","year":"2025","unstructured":"Kawczak, P., Feszak, I. J. & B\u0105czek, T. Comparative Mechanistic Insights and Therapeutic Potential of Pembrolizumab, Durvalumab, and Ipilimumab as Immune Checkpoint Inhibitors in the Targeted Management of Oral and Head and Neck Squamous Cell Carcinoma. Cancers (Basel). 17 (17), 2805 (2025).","journal-title":"Cancers (Basel)"},{"key":"60283_CR54","doi-asserted-by":"publisher","first-page":"1383456","DOI":"10.3389\/fimmu.2024.1383456","volume":"15","author":"SA Javed","year":"2024","unstructured":"Javed, S. A., Najmi, A., Ahsan, W., Zoghebi, K. & Targeting PD-1\/PD-L-1 immune checkpoint inhibition for cancer immunotherapy: success and challenges. Front. Immunol. 15, 1383456 (2024).","journal-title":"Front. Immunol."},{"key":"60283_CR55","doi-asserted-by":"publisher","first-page":"107230","DOI":"10.1016\/j.lungcan.2023.107230","volume":"181","author":"M Ili\u00e9","year":"2023","unstructured":"Ili\u00e9, M. et al. Lack of correlation between MET and PD-L1 expression in non-small cell lung cancer revealed by comparative study of matched biopsies and surgical resection samples. Lung Cancer. 181, 107230 (2023).","journal-title":"Lung Cancer"},{"issue":"17","key":"60283_CR56","doi-asserted-by":"publisher","first-page":"1858","DOI":"10.3390\/diagnostics14171858","volume":"14","author":"L Bernadett","year":"2024","unstructured":"Bernadett, L. et al. No Correlation between PD-L1 and NIS Expression in Lymph Node Metastatic Papillary Thyroid Carcinoma. Diagnostics 14 (17), 1858 (2024).","journal-title":"Diagnostics"},{"key":"60283_CR57","doi-asserted-by":"publisher","first-page":"1337582","DOI":"10.3389\/froh.2024.1337582","volume":"5","author":"J Hanroongsri","year":"2024","unstructured":"Hanroongsri, J., Amornphimoltham, P., Younis, R. H. & Chaisuparat, R. Expression of PD-L1 and p-RPS6 in epithelial dysplasia and squamous cell carcinoma of the oral cavity. Front. Oral Heal. 5, 1337582 (2024).","journal-title":"Front. Oral Heal"},{"key":"60283_CR58","doi-asserted-by":"publisher","first-page":"1581275","DOI":"10.3389\/fonc.2025.1581275","volume":"15","author":"GW Vainer","year":"2025","unstructured":"Vainer, G. W. et al. Unraveling the complexity of PD-L1 assays: a descriptive review of the methodology, scoring, and practical implications. Front. Oncol. 15, 1581275 (2025).","journal-title":"Front. Oncol."},{"issue":"2","key":"60283_CR59","doi-asserted-by":"publisher","first-page":"e108","DOI":"10.1111\/ajco.13102","volume":"16","author":"S Kamiya","year":"2020","unstructured":"Kamiya, S. et al. Association between PD-L1 expression and lymph node metastasis in cutaneous squamous cell carcinoma. Asia-Pacific J. Clin. Oncol. 16 (2), e108\u2013e112 (2020).","journal-title":"Asia\u2010Pacific J. Clin. Oncol."}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-60283-6","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-60283-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-60283-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T23:04:27Z","timestamp":1783206267000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-60283-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,4]]},"references-count":59,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["60283"],"URL":"https:\/\/doi.org\/10.1038\/s41598-026-60283-6","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,4]]},"assertion":[{"value":"15 March 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 June 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 July 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"Ethical Approval was obtained before the study from the Ethics Committee of the Faculty of Dentistry, Mansoura University, Egypt, under the code number: A23080622op.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}}],"article-number":"20566"}}