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To examine the prevalence and prognostic role of tumor microenvironment (TME) markers in uterine carcinosarcoma (UCS) through immunohistochemical characterization. Methods: The internal database of our institution was queried out for women with UCS who underwent surgery and thereafter postoperative chemotherapy with carboplatin and paclitaxel between January 2012 and December 2017. | da Silva et al. BMC Cancer 2021 21 1306 https doi.org 10.1186 s12885-021-09026-6 RESEARCH Open Access The prevalence and prognostic impact of tumor-infiltrating lymphocytes in uterine carcinosarcoma Jesse Lopes da Silva1 2 Lucas Zanetti de Albuquerque1 Fabiana Resende Rodrigues3 Guilherme Gomes de Mesquita1 3 Cláudia Bessa Pereira Chaves1 2 Martín Hernán Bonamino4 5 and Andreia Cristina de Melo1 Abstract Objective To examine the prevalence and prognostic role of tumor microenvironment TME markers in uterine carcinosarcoma UCS through immunohistochemical characterization. Methods The internal database of our institution was queried out for women with UCS who underwent surgery and thereafter postoperative chemotherapy with carboplatin and paclitaxel between January 2012 and December 2017. Tissue microarrays containing surgical samples of UCS from 57 women were assessed by immunohistochemistry for CD3 CD4 CD8 FOXP3 PD-1 PD-L1 and PD-L2. Results The mean age was 65.3 years range 49 to 79 years . For the epithelial component E CD3_E and CD4_E were highly expressed in 38 66.7 and in 40 70.1 patients respectively and were significantly associated with more advanced stages p 0.038 and p 0.025 respectively . CD8_E was highly expressed in 42 73.7 patients FOXP3_E 16 28.1 PD-1_E 35 61.4 PD-L1_E 27 47.4 and PD-L2_E 39 68.4 . For the sarcomatous compo- nent S the prevalence of high expression was CD3_S 6 10.5 CD4_S 20 35.1 CD8_S 44 77.2 FOXP3_S 8 14 PD-1_S 14 24.6 PD-L1_S 14 24.6 and PD-L2_S 8 14 . By multivariate analysis the CD8 FOXP3_S ratio p 0.026 CD4_E p 0.010 PD-L1_E p 0.013 and PD-L1_S p 0.008 markers significantly influenced progres- sion-free survival. CD4 FOXP3_S ratio p 0.043 PD-1_E p 0.011 PD-L1_E p 0.036 and PD-L1_S p 0.028 had a significant association with overall survival. Conclusion Some differences in UCS clinical outcomes may be due to the subtype of TILs and PD-1 PD-L1 axis immune checkpoint signaling. Keywords Uterine carcinosarcoma Tumor-infiltrating .
