{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T03:48:34Z","timestamp":1761709714540,"version":"build-2065373602"},"reference-count":38,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2020,6,11]],"date-time":"2020-06-11T00:00:00Z","timestamp":1591833600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004515","name":"Universiti Kebangsaan Malaysia","doi-asserted-by":"publisher","award":["FF-2018-052"],"award-info":[{"award-number":["FF-2018-052"]}],"id":[{"id":"10.13039\/501100004515","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Endometrial carcinoma is the only gynaecologic malignancy with a raising incidence and mortality, posing a major health concern worldwide. The upregulation of programmed death ligand 1 (PD-L1) on tumour cells causes T-cell suppression, which impedes antitumour immunity, promotes immune cell evasion and enhances tumour survival. The aim of this study was to evaluate PD-L1 expression in endometrial carcinoma and to correlate it with survival rate. A total of 59 cases of endometrial carcinoma were evaluated. Thirty-two cases of non-neoplastic endometrial tissue were included as control. PD-L1 immunohistochemistry was performed on all cases. PD-L1 expression was evaluated on tumour cells and immune cells. PD-L1 was positive in 62.7% (37\/59) and 28.8% (17\/59) of immune cells and tumour cells, respectively. PD-L1 expression in immune cells was significantly higher in endometrial carcinoma than in non-neoplastic endometrium (p &lt; 0.001). Among the patients with endometrial carcinoma, PD-L1 expression in tumour cells was significantly higher in patients who died (10\/15, 66.7%) compared to those who survived (7\/44, 15.9%) (p &lt; 0.001). It is noteworthy to point out that the expression of PD-L1 in tumour cells was significantly associated with a poor survival. This suggests that immunomodulation using PD-L1 inhibitors may be useful in advanced endometrial carcinoma.<\/jats:p>","DOI":"10.3390\/diagnostics10060394","type":"journal-article","created":{"date-parts":[[2020,6,12]],"date-time":"2020-06-12T05:02:24Z","timestamp":1591938144000},"page":"394","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Programmed Death Ligand 1: A Poor Prognostic Marker in Endometrial Carcinoma"],"prefix":"10.3390","volume":"10","author":[{"given":"Mianxin","family":"Chew","sequence":"first","affiliation":[{"name":"Department of Pathology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Kuala Lumpur 56000, Malaysia"},{"name":"Department of Pathology, Hospital Raja Permaisuri Bainun, Jalan Raja Ashman Shah, Ipoh 30450, Perak Darul Ridzuan, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4897-9927","authenticated-orcid":false,"given":"Yin Ping","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of Pathology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Kuala Lumpur 56000, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Norain","family":"Karim","sequence":"additional","affiliation":[{"name":"Department of Pathology, Hospital Raja Permaisuri Bainun, Jalan Raja Ashman Shah, Ipoh 30450, Perak Darul Ridzuan, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muaatamarulain","family":"Mustangin","sequence":"additional","affiliation":[{"name":"Department of Pathology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Kuala Lumpur 56000, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nurwardah","family":"Alfian","sequence":"additional","affiliation":[{"name":"Department of Pathology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Kuala Lumpur 56000, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2289-7619","authenticated-orcid":false,"given":"Geok Chin","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Pathology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Kuala Lumpur 56000, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2020,6,11]]},"reference":[{"key":"ref_1","unstructured":"(2019, November 12). National Cancer Institute: SEER Stat Fact Sheets: Endometrial Cancer, Available online: https:\/\/seer.cancer.gov\/statfacts\/html\/corp.html."},{"key":"ref_2","unstructured":"(2020, February 15). The Malaysian National Cancer Registry Report (MNCR) 2007\u20132011. Available online: https:\/\/kpkesihatan.com\/2016\/12\/07\/the-malaysian-national-cancer-registry-report-mncr-2007-2011\/."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1186\/s40661-015-0020-3","article-title":"Immunotherapy in endometrial cancer-an evolving therapeutic paradigm. Gynecologic oncology research and practice","volume":"2","author":"Longoria","year":"2015","journal-title":"Gynecol. Oncol. Res. Pract."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"354","DOI":"10.1093\/jnci\/djx214","article-title":"International Patterns and Trends in Endometrial Cancer Incidence, 1978\u20132013","volume":"110","author":"Ferlay","year":"2018","journal-title":"J. Natl. Cancer Inst."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/0090-8258(83)90111-7","article-title":"Two pathogenetic types of endometrial carcinoma","volume":"15","author":"Bokhman","year":"1983","journal-title":"Gynecol. Oncol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"2607","DOI":"10.1200\/JCO.2012.48.2596","article-title":"Type I and II endometrial cancers: Have they different risk factors?","volume":"31","author":"Setiawan","year":"2013","journal-title":"J. Clin. Oncol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"788","DOI":"10.1200\/JCO.2009.24.1315","article-title":"Absolute risk of endometrial carcinoma during 20-year follow-up among women with endometrial hyperplasia","volume":"28","author":"Lacey","year":"2010","journal-title":"J. Clin. Oncol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"944","DOI":"10.3892\/ol.2016.4744","article-title":"Expression of PD-1, PD-L1 and PD-L2 is associated with differentiation status and histological type of endometrial cancer","volume":"12","author":"Mo","year":"2016","journal-title":"Oncol. Lett."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2159","DOI":"10.1200\/JCO.2004.07.184","article-title":"Phase III trial of doxorubicin plus cisplatin with or without paclitaxel plus filgrastim in advanced endometrial carcinoma: A Gynecologic Oncology Group Study","volume":"22","author":"Fleming","year":"2004","journal-title":"J. Clin. Oncol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1016\/j.ctrv.2006.10.007","article-title":"Systemic therapy in metastatic or recurrent endometrial cancer","volume":"33","author":"Pectasides","year":"2007","journal-title":"Cancer Treat. Rev."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1038\/nrc3239","article-title":"The blockade of immune checkpoints in cancer immunotherapy","volume":"12","author":"Pardoll","year":"2012","journal-title":"Nat. Rev. Cancer"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1365","DOI":"10.1038\/70932","article-title":"B7-H1, a third member of the B7 family, co-stimulates T-cell proliferation and interleukin-10 secretion","volume":"5","author":"Dong","year":"1999","journal-title":"Nat. Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1093\/intimm\/dxu095","article-title":"Therapeutic uses of anti-PD-1 and anti-PD-L1 antibodies","volume":"27","author":"Philips","year":"2014","journal-title":"Int. Immunol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2433","DOI":"10.1093\/annonc\/mdu452","article-title":"PD-L1 marks a subset of melanomas with a shorter overall survival and distinct genetic and morphological characteristics","volume":"25","author":"Massi","year":"2014","journal-title":"Ann. Oncol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1007\/s11523-015-0392-7","article-title":"Prognostic role of PD-L1 expression in renal cell carcinoma. A systematic review and meta-analysis","volume":"11","author":"Iacovelli","year":"2016","journal-title":"Target. Oncol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1001\/jamaoncol.2015.3638","article-title":"Quantitative assessment of the heterogeneity of PD-L1 expression in non\u2013small-cell lung cancer","volume":"2","author":"McLaughlin","year":"2016","journal-title":"JAMA Oncol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1016\/j.ygyno.2015.01.514","article-title":"PD-1 and PD-L1 expression in 1599 gynecological malignancies: Implications for immunotherapy","volume":"137","author":"Herzog","year":"2015","journal-title":"Gynecol Oncol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1097\/PAI.0000000000000457","article-title":"PD-L1 Expression in carcinosarcomas of the gynecologic Tract: A potentially actionable biomarker","volume":"26","author":"Pinto","year":"2018","journal-title":"Appl. Immunohistochem. Mol. Morphol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1007\/s00262-014-1537-8","article-title":"Mapping the immunosuppressive environment in uterine tumors: Implications for immunotherapy","volume":"63","author":"Vanderstraeten","year":"2014","journal-title":"Cancer Immunol. Immun."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1016\/j.critrevonc.2016.02.001","article-title":"PD-L1 expression in cancer patients receiving anti PD-1\/PD-L1 antibodies: A systematic review and meta-analysis","volume":"100","author":"Gandini","year":"2016","journal-title":"Crit. Rev. Oncol. Hemat."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1093\/jnci\/85.3.200","article-title":"Association of p53 protein expression with tumor cell proliferation rate and clinical outcome in node-negative breast cancer","volume":"85","author":"Allred","year":"1993","journal-title":"J. Natl. Cancer Inst."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1038\/s41416-018-0144-4","article-title":"Expression patterns of programmed death ligand 1 correlate with different microenvironments and patient prognosis in hepatocellular carcinoma","volume":"119","author":"Liu","year":"2018","journal-title":"Br J Cancer."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"e79","DOI":"10.1097\/PAI.0000000000000590","article-title":"Expression of PD-L1 on immune cells shows better prognosis in laryngeal, oropharygeal, and hypopharyngeal cancer","volume":"26","author":"Birtalan","year":"2018","journal-title":"Appl. Immunohistochem. Mol. Morphol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1186\/s13048-018-0414-z","article-title":"Stratification of ovarian tumor pathology by expression of programmed cell death-1 (PD-1) and PD-ligand- 1 (PD-L1) in ovarian cancer","volume":"11","author":"Drakes","year":"2018","journal-title":"J. Ovarian Res."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"5606","DOI":"10.4049\/jimmunol.1003976","article-title":"B7-h1 expressed by activated CD8 T-cells is essential for their survival","volume":"187","author":"Pulko","year":"2011","journal-title":"J Immunol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1073","DOI":"10.3389\/fonc.2019.01073","article-title":"The Controversial Role of PD-1 and Its Ligands in Gynecological Malignancies","volume":"9","author":"Marinelli","year":"2019","journal-title":"Front. Oncol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1097\/PGP.0000000000000543","article-title":"Expression of immunomodulatory molecules PD-1, PD-L1, and PD-L2, and their relationship with clinicopathologic characteristics in endometrial cancer","volume":"38","author":"Sungu","year":"2019","journal-title":"Int. J. Gynecol. Pathol."},{"key":"ref_28","unstructured":"Panawala, L. (2020, February 15). Difference between Monoclonal and Polyclonal Antibodies. Available online: https:\/\/www.researchgate.net\/publication\/320707210_Difference_Between_Monoclonal_and_Polyclonal_Antibodies."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"5023","DOI":"10.2147\/OTT.S105862","article-title":"PD-L1 expression in human cancers and its association with clinical outcomes","volume":"9","author":"Wang","year":"2016","journal-title":"Onco Targets Ther."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"e6369","DOI":"10.1097\/MD.0000000000006369","article-title":"Prognostic significance of PD-L1 in solid tumor: An updated meta-analysis","volume":"96","author":"Wang","year":"2017","journal-title":"Medicine"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Zhang, S., Minaguchi, T., Xu, C., Qi, N., Itagaki, H., Shikama, A., Tasaka, N., Akiyama, A., Sakurai, M., and Ochi, H. (2020). PD-L1 and CD4 are independent prognostic factors for overall survival in endometrial carcinomas. BMC Cancer, 20.","DOI":"10.1186\/s12885-020-6545-9"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1016\/j.ygyno.2020.01.020","article-title":"High degree of heterogeneity of PD-L1 and PD-1 from primary to metastatic endometrial cancer","volume":"157","author":"Engerud","year":"2020","journal-title":"Gynecol. Oncol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1046\/j.1525-1438.2000.010003212.x","article-title":"Prognostic factors in young women with endometrial carcinoma: A report of 20 cases and review of literature","volume":"10","author":"Yamazawa","year":"2000","journal-title":"Int. J. Gynecol. Cancer."},{"key":"ref_34","first-page":"70","article-title":"Endometrial cancer and microsatellite instability status","volume":"10","author":"Kanopiene","year":"2014","journal-title":"Open Med. (Wars)"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1136\/jclinpath-2017-204853","article-title":"PD-L1","volume":"71","author":"Kythreotou","year":"2018","journal-title":"J. Clin. Pathol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1016\/S1074-7613(00)80089-8","article-title":"Development of lupus-like autoimmune diseases by disruption of the PD-1 gene encoding an ITIM motif-carrying immunoreceptor","volume":"11","author":"Nishimura","year":"1999","journal-title":"Immunity"},{"key":"ref_37","first-page":"1432","article-title":"Breakthrough of the year 2013","volume":"342","year":"2013","journal-title":"Cancer Immunother. Sci."},{"key":"ref_38","unstructured":"(2020, January 12). Cancer Research Institute. Available online: https:\/\/www.cancerresearch.org\/scientists\/immuno-oncology-landscape\/fda-approval-timeline-of-active-immunotherapies."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/10\/6\/394\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T09:37:43Z","timestamp":1760175463000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/10\/6\/394"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,6,11]]},"references-count":38,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2020,6]]}},"alternative-id":["diagnostics10060394"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics10060394","relation":{},"ISSN":["2075-4418"],"issn-type":[{"type":"electronic","value":"2075-4418"}],"subject":[],"published":{"date-parts":[[2020,6,11]]}}}