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May 31, 2026Cancers0 citationsOpen Access

The Prognostic Potential of PD-L1, PD-1, CD3, CD4, and CD8 Expression in Patients with Head and Neck Cancers Depending on HPV16 Infection

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AMAnna Mucha-MałeckaNational Institute of OncologyBBBeata BiesagaNational Institute of OncologyNANatalia AmrogowiczNational Institute of Oncology

Key Points

  • This study aims to evaluate the expression of immune markers in head and neck cancers and their prognostic value regarding disease-free survival in relation to HPV16 status.
  • Included 155 patients with head and neck squamous cell carcinoma from southern Poland.
  • Used immunohistochemistry to assess protein expression of PD-L1, PD-1, CD3, CD4, and CD8.
  • Analyzed relationships between expression levels and clinical, pathological, and demographic factors.
  • PD-L1 overexpression linked to worse disease-free survival (DFS), while PD-1, CD3, CD4, and CD8 overexpression correlated with improved DFS in HPV16-negative patients.
  • Statistically significant correlations were found solely in the HPV16-negative subgroup.
  • Independent prognostic factors for better DFS included HPV16 infection, absence of PD-L1 overexpression, and increased CD4 and CD8 expression.

Abstract

Objective: The aim of this study was to evaluate the expression of PD-L1, PD-1, CD3, CD4, and CD8 in tumor tissues of patients with head and neck squamous cell carcinoma from southern Poland, and to assess their prognostic value in relation to disease-free survival (DFS), taking into account HPV16 status and other clinical, pathological, and demographic factors. Material/Methods: This study included 155 unselected patients with head and neck squamous cell carcinoma (HNSCC) from the southern Poland region, who underwent diagnostic evaluation and surgical treatment. Formalin-fixed, paraffin-embedded (FFPE) tissue blocks were obtained from these centers. The patients were treated at the Maria Skłodowska-Curie National Research Institute of Oncology, Kraków Branch, between 1991 and 2014, with treatment approaches including induction therapy (preoperative), adjuvant therapy (postoperative), or definitive chemoradiotherapy with cisplatin. Protein expression was assessed using immunohistochemistry and quantified (TPS, CPS, H-score). Relationships between expression levels and epidemiological, clinical, and histopathological features were analyzed. Results: The results show that PD-L1 overexpression was associated with worse DFS, whereas overexpression of PD-1, CD3, CD4, and CD8 correlated with improved DFS. These associations were statistically significant in the HPV16-negative subgroup, while no such correlations were found in HPV16-positive patients. In multivariate analysis, independent prognostic factors associated with improved DFS included HPV16 infection, absence of PD-L1 overexpression, overexpression of CD4 and CD8, and combined chemoradiotherapy with cisplatin. Conclusions: These findings confirm the prognostic relevance of PD-L1, PD-1, and T-cell markers in HNSCC, particularly in HPV16-negative patients, and support further research into the use of these biomarkers in personalized treatment strategies.

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Cite This Study

Mucha-Małecka et al. (2026) studied this question.

synapsesocial.com/papers/6a1bd1db5783ba022b6fd46chttps://doi.org/10.3390/cancers18111771
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