Evidence map›Paper›PMID 31993774›Full record

ArticleVirchows Archiv : an international journal of pathology2020

Immune checkpoint status and tumor microenvironment in vulvar squamous cell carcinoma.

Margaret Cocks, Alcides Chaux, Erik G Jenson, James A Miller, Maria Del Carmen Rodriguez Pena, Aline C Tregnago, Diana Taheri, Marie-Lisa Eich, Rajni Sharma, Russell Vang and 1 more

Abstract read
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In one paragraph

Article in Virchows Archiv : an international journal of pathology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed, 2 pooled it
1.3field-weighted citation impact, top 17% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

12 citing papers in PubMed, 2 syntheses or guidelines pooled it, 30 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Nectin-4 expression in vulvar squamous cell carcinoma.Virchows Archiv : an international journal of pathology · 2026
    Article
  4. Review
  5. Review
  6. Clinical, histopathological and immunohistochemical analysis of vulvar squamous cell carcinoma.Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia · 2024
    Article
  7. Article
  8. Article
  9. Article
  10. Review
  11. Review
  12. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 4 institutions in 4 countries.

Margaret CocksDepartment of Pathology, The Johns Hopkins Hospital, Baltimore, MD, USA.
Alcides ChauxDepartment of Scientific Research, School of Postgraduate Studies, Norte University, Asunción, Paraguay.
Erik G JensonDepartment of Pathology, The Johns Hopkins Hospital, Baltimore, MD, USA.
James A MillerDepartment of Pathology, The Johns Hopkins Hospital, Baltimore, MD, USA.
Maria Del Carmen Rodriguez PenaDepartment of Pathology, The University of Alabama at Birmingham, West Pavilion P210, 619 19th Street, South Birmingham, AL, 35249-7331, USA.
Aline C TregnagoDepartment of Pathology, The Johns Hopkins Hospital, Baltimore, MD, USA.
Diana TaheriDepartment of Pathology, The Johns Hopkins Hospital, Baltimore, MD, USA.
Marie-Lisa EichDepartment of Pathology, The University of Alabama at Birmingham, West Pavilion P210, 619 19th Street, South Birmingham, AL, 35249-7331, USA.
Rajni SharmaDepartment of Pathology, The Johns Hopkins Hospital, Baltimore, MD, USA.
Russell VangDepartment of Pathology, The Johns Hopkins Hospital, Baltimore, MD, USA.
George J NettoDepartment of Pathology, The University of Alabama at Birmingham, West Pavilion P210, 619 19th Street, South Birmingham, AL, 35249-7331, USA. gnetto@uabmc.edu.ORCID http://orcid.org/0000-0003-3915-9134
Johns Hopkins Hospital · USUniversity of Alabama at Birmingham · USIsfahan University of Medical Sciences · IRUniversidad del Norte · PY

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Vulvar squamous cell carcinoma accounts for 5% of cancers of the female genital tract. Current guidelines recommend wide local excision with negative surgical margins as the standard treatment. However, the extent of the tumor-free resection margin after wide local excision is still controversial in many cases. Drugs targeting immune checkpoints such as PD-1 or its ligand PD-L1 have potential clinical utility in these patients. We examined the expression of PD-L1 in tumor cells and immune cells, as well as the proportion of PD-1, CD8, and FOXP3 positive lymphocytes. Twenty-one cases of invasive vulvar squamous cell carcinomas were reviewed. Whole slides of representative formalin-fixed, paraffin-embedded archival material were used for analysis. Odds ratios (OR) and hazard ratios (HR) were used to estimate risk for disease recurrence, overall mortality, and cancer mortality. PD-L1 expression was found in 43% of tumor cells, with higher proportions in intratumoral (67%) and peritumoral (81%) immune cells. OR and HR for disease recurrence and cancer mortality were higher in tumors with higher CD8 expression. OR and HR for overall mortality were also higher in tumors with higher PD-L1 and CD8 expression. In conclusion, nearly half of cases were PD-L1 positive in tumor cells with over two-third of cases demonstrating PD-L1 positivity in immune cells. Immunohistochemical expression of PD-L1 and CD8 could be used to suggest higher risk of disease recurrence, overall mortality, and cancer mortality. Furthermore, our data contributes to the growing evidence that targeting the PD-1/PD-L1 pathway may be beneficial in vulvar squamous cell carcinomas.

Indexed as

AdultAgedAged, 80 and overB7-H1 AntigenBiomarkers, TumorCarcinoma, Squamous CellFemaleHumansLymphocytes, Tumor-InfiltratingMiddle AgedNeoplasm Recurrence, LocalTumor MicroenvironmentVulvar NeoplasmsB7-H1 AntigenBiomarkers, TumorCD274 protein, humanCheckpoint inhibitorImmunotherapyOutcomePD-1PD-L1PrognosisSquamous cell carcinomaTumor microenvironmentVulva

Identifiers

PMID31993774
OpenAlexW3003376133

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.