{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T16:12:05Z","timestamp":1791821525706,"version":"4.3.4"},"reference-count":30,"publisher":"Korean Cancer Association","issue":"3","license":[{"start":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T00:00:00Z","timestamp":1755043200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/3.0\/"}],"funder":[{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","award":["RS-2024-00337453"],"award-info":[{"award-number":["RS-2024-00337453"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100014188","name":"Ministry of Science and ICT","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100014188","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100003653","name":"Korea National Institute of Health","doi-asserted-by":"publisher","award":["2025-ER1104-00"],"award-info":[{"award-number":["2025-ER1104-00"]}],"id":[{"id":"10.13039\/501100003653","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["e-crt.org"],"crossmark-restriction":true},"short-container-title":["Cancer Res Treat"],"published-print":{"date-parts":[[2026,7,15]]},"abstract":"<jats:p>Purpose Programmed cell death ligand-1 (PD-L1) negatively regulates T-cell activation, and exhibits sex-based differences in expression and immune responses. This study investigated sex-related differences in clinicopathological factors influencing PD-L1 expression and the effect of immune checkpoint inhibitors (ICIs) on survival in gastric cancer (GC) patients in South Korea.Materials and Methods We analyzed a prospective cohort of 468 GC patients who underwent PD-L1 immunohistochemistry. Age, tumor characteristics, molecular features, and survival outcomes were compared by sex. Multivariate analyses, including Cox proportional hazards modeling with an interaction term for sex, were performed.Results Among 468 patients, 280 (59.8%) were PD-L1 positive. In the overall cohort, PD-L1 positivity was significantly associated with Epstein-Barr virus (EBV) infection (odds ratio [OR], 7.46; p &lt; 0.001), antral location of GC (OR, 1.84; p=0.027), and macrosatellite instability\u2013high (MSI-H) (OR, 5.04; p=0.027). Diffuse-type histology was inversely associated (OR, 0.22; p=0.041). In males, EBV (OR, 36.27) and antral location (OR, 2.38) were significant. In females, only MSI-H was significant (OR, 11.63). ICI-containing therapy significantly improved survival in males (p=0.012) but not in females (p=0.415). Cox regression showed a survival benefit from ICIs (hazard ratio, 0.70; p=0.080), with a borderline-significant interaction by sex (p=0.073).Conclusion PD-L1 expression and therapeutic efficacy of ICIs differ by sex in GC. EBV infection and antral tumor location were independent factors in males, while MSI-H status was significant in females. These findings highlight the importance of sex-based immunobiology in tailoring GC treatment strategies.<\/jats:p>","DOI":"10.4143\/crt.2025.126","type":"journal-article","created":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T01:55:49Z","timestamp":1755050149000},"page":"860-871","update-policy":"https:\/\/doi.org\/10.4143\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Clinicopathological Factors Influencing PD-L1 Expression and the Effect of Immune Checkpoint Inhibitors on Survival Outcomes in Patients with Gastric Cancer Depending on Sex in a Tertiary Hospital in South Korea"],"prefix":"10.4143","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-6986-5723","authenticated-orcid":true,"given":"Jeong hwan","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9397-0406","authenticated-orcid":true,"given":"Nayoung","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea"},{"name":"Research Center for Sex- and Gender-Specific Medicine, Seoul National University Bundang Hospital, Seongnam, Korea"},{"name":"Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji-Hyun","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyeon Jeong","family":"Oh","sequence":"additional","affiliation":[{"name":"Department of Pathology, Seoul National University Bundang Hospital, Seongnam, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yeejin","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yonghoon","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyemin","family":"Jo","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ho-Kyoung","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinju","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu Kyung","family":"Jun","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyuk","family":"Yoon","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheol Min","family":"Shin","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Young Soo","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dong Ho","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea"},{"name":"Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hye Seung","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Pathology, Seoul National University College of Medicine, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"So Hyun","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Young Suk","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sang-Hoon","family":"Ahn","sequence":"additional","affiliation":[{"name":"Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun-Suhk","family":"Suh","sequence":"additional","affiliation":[{"name":"Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Do Joong","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Surgery, Seoul National University College of Medicine, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyung 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University College of Medicine, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Won","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Radiology, Seoul National University Bundang Hospital, Seongnam, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoon Jin","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Radiology, Seoul National University Bundang Hospital, Seongnam, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyoung Ho","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Radiology, Seoul National University Bundang Hospital, Seongnam, Korea"},{"name":"Department of Radiology, Seoul National University College of Medicine, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Young Hoon","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Radiology, Seoul National University 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