OBJECTIVE To investigate the role of programmed death-1 (PD-1), programmed death-ligand 1 (PD-L1), and P16 in patients with head and neck squamous cell carcinoma (HNSCC). METHODS A total of 95 paraffin-embedded samples of tumorous tissue of HNSCC were collected. Expression levels of PD-1, PD-L1, and P16 were determined by immunohistochemistry. RESULTS A significantly higher proportion of PD-1 among patients infected with the human papillomavirus was found. PD-L1 expression is closely associated with the primary site of the tumor, postoperative recurrence, survival, PD-1 expression and P16 expression. Univariable analysis indicated that T stage, N stage, tumor node metastasis stage, tumor differentiation, and PD-L1 expression were all shown to be prognostic variables for overall survival in patients with HNSCC. In the multivariate analysis, only N stage (P = 0.010) and PD-L1 expression (P = 0.001) were found to be independent prognostic variables for overall survival. In addition, for disease recurrence, multivariate analysis showed that only PD-L1 expression was the associated independent risk factor. For the patients with negative PD-L1 expression, Kaplan-Meier analysis revealed that they had significantly worse outcomes in terms of overall survival (P = 0.001). Similarly, compared with the patients with positive PD-L1 expression, those with negative PD-L1 expression had a higher probability of recurrence (P = 0.026). CONCLUSIONS The expression of PD-L1, PD-1, and P16 in HNSCC is significantly correlated. Human papillomavirus infection (P16 positive) is negatively related to postoperative recurrence. HNSCC patients with positive PD-L1/PD-1 expression tend to have better overall survival outcomes and lower probability of recurrence, providing more evidence for the PD-l-targeted immunotherapy of HNSCC.

中文翻译：

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PD-1/PD-L1在头颈部鳞状细胞癌中的表达及其临床意义

目的探讨程序性死亡1（PD-1）、程序性死亡配体1（PD-L1）和P16在头颈部鳞状细胞癌（HNSCC）患者中的作用。方法共收集95份石蜡包埋的HNSCC肿瘤组织样本。通过免疫组织化学测定 PD-1、PD-L1 和 P16 的表达水平。结果发现感染人乳头瘤病毒的患者中PD-1的比例明显更高。PD-L1表达与肿瘤原发部位、术后复发、生存、PD-1表达和P16表达密切相关。单变量分析表明，T 分期、N 分期、肿瘤淋巴结转移分期、肿瘤分化和 PD-L1 表达均被证明是 HNSCC 患者总生存期的预后变量。在多元分析中，只有 N 期 (P = 0.010) 和 PD-L1 表达 (P = 0.001) 被发现是总生存期的独立预后变量。此外，对于疾病复发，多变量分析显示只有 PD-L1 表达是相关的独立危险因素。对于 PD-L1 表达阴性的患者，Kaplan-Meier 分析显示他们的总生存期明显更差（P = 0.001）。同样，与PD-L1表达阳性的患者相比，PD-L1表达阴性的患者复发概率更高（P = 0.026）。结论 HNSCC中PD-L1、PD-1、P16的表达存在显着相关性。人乳头瘤病毒感染（P16阳性）与术后复发呈负相关。