Objective

To characterize T lymphocyte infiltration and programmed cell death protein-1 (PD-1)/programmed death-ligand 1 (PD-L1) expression in early-stage endometriosis-associated ovarian cancer (EAOC), ovarian endometriosis (OE), atypical endometriosis (AE), and deep endometriosis (DE).

Design

Case-control, retrospective study.

Setting

Research University Hospital.

Patient(s)

A total of 362 patients with a histologic diagnosis of EAOC, OE, AE, or DE were identified between 2000 and 2019 from Fondazione Policlinico Universitario Agostino Gemelli IRCCS and Gemelli Molise SpA tissue data banks. A 1:1 propensity score-matched method yielded matched pairs of 55 subjects with EAOC, 55 patients with OE, 12 patients with AE, and 42 patients with DE, resulting in no differences in family history of cancer, parity, and use of oral contraceptives.

Intervention(s)

Immunohistochemistry assays using the following primary antibodies: CD3+; CD4+; CD8+; PD-1; and PD-L1.

Main Outcome Measure(s)

To characterize T lymphocyte infiltration and PD-1/PD-L1 expression in 4 different endometriosis-related diseases.

Result(s)

Endometriosis-associated ovarian cancer cases displayed significantly higher levels of PD-1/PD-L1 expression compared with all other endometriosis-related diseases (vs. OE vs. AE vs. DE). Moreover, a significantly lower count of infiltrating T lymphocytes was observed in EAOC cases compared with OE ones. Finally, one-third of OE cases showed a cancer-like PD-1/PD-L1 expression profile.

Conclusion(s)

Endometriosis-associated ovarian cancer is characterized by higher levels of PD-1/PD-L1 expression compared with benign endometriosis-related diseases. This profile was found in one-third of clinically benign cases, suggesting that it develops early in the carcinogenesis process.

中文翻译：

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子宫内膜异位症相关卵巢癌中浸润 T 淋巴细胞和程序性细胞死亡蛋白 1/程序性死亡配体 1 的表达

客观的

表征早期子宫内膜异位症相关卵巢癌 (EAOC)、卵巢子宫内膜异位症 (OE)、非典型子宫内膜异位症中的 T 淋巴细胞浸润和程序性细胞死亡蛋白-1 (PD-1)/程序性死亡配体 1 (PD-L1) 表达(AE) 和深部子宫内膜异位症 (DE)。

设计

病例对照，回顾性研究。

环境

研究型大学医院。

耐心）

2000 年至 2019 年间，从 Fondazione Policlinico Universitario Agostino Gemelli IRCCS 和 Gemelli Molise SpA 组织数据库中确定了 362 名组织学诊断为 EAOC、OE、AE 或 DE 的患者。采用 1:1 倾向评分匹配方法，55 名 EAOC 受试者、55 名 OE 患者、12 名 AE 患者和 42 名 DE 患者配对，导致癌症家族史、产次和口服药物的使用没有差异避孕药。

干预措施

使用以下一抗进行免疫组织化学检测：CD3+；CD4+；CD8+；PD-1；和 PD-L1。

主要观察指标）

表征 4 种不同子宫内膜异位症相关疾病中的 T 淋巴细胞浸润和 PD-1/PD-L1 表达。

结果）

与所有其他子宫内膜异位症相关疾病相比，子宫内膜异位症相关卵巢癌病例的 PD-1/PD-L1 表达水平显着升高（与 OE、AE、DE 相比）。此外，与 OE 病例相比，在 EAOC 病例中观察到浸润性 T 淋巴细胞计数显着降低。最后，三分之一的 OE 病例显示出类似癌症的 PD-1/PD-L1 表达谱。

结论

与良性子宫内膜异位症相关疾病相比，子宫内膜异位症相关卵巢癌的特点是 PD-1/PD-L1 表达水平更高。在三分之一的临床良性病例中发现了这种情况，表明它在癌变过程的早期发展。