The immune checkpoints CTLA-4 and PD-L1 in carcinomas of the uterine cervix

Background: Evasion of immune control is a major feature of malignant tumors. This tumor aspect is poorly studied in cervical lesions. Aim of the study: To investigate the expression of PD-L1 and CTLA-4 in lesions of the uterine cervix. Material and methods: Sixty-three cervical lesions from 52 patients were immunohistochemically studied. The 63 lesions included 27 invasive adenocarcinomas, 19 squamous cell carcinomas (SCCs), 7 adenocarcinomas in situ, and 10 high-grade squamous intraepithelial lesions (CIN3). Results: CTLA-4 and PD-L1 tumor cell expression was found in 61.5 % and 26.9 % of the invasive cases, respectively. CTLA-4 tumor cell expression and PD-L1 tumor and immune cell expression were more often found in SCCs than in adenocarcinomas. CTLA-4 tumor cell expression was more often found in advanced FIGO tumors. PD-L1 and CTLA-4 immune cell expression was associated with lymph node metastasis. CTLA-4 expression did not affect survival. The prognosis was worse for PD-L1-expressing tumors. Conclusion: CTLA-4 and PD-L1 are potential therapeutic targets in cervical cancer.