Immunohistochemical expression of PD-L1 in colorectal carcinoma among black patients and the clinicopathological correlates: a cross-sectional study

Abstract

BACKGROUND: Colorectal cancer (CRC) incidence is rising in Nigeria, with majority of patients presenting with advanced disease. Despite promising results of PD-L1 antibody therapy in clinical trials, efficacy data exclusively derives from Caucasian populations, leaving a critical knowledge gap for African populations. This study investigated PD-L1 expression in CRC among blacks, correlating it with clinicopathologic parameters. METHODS: The immunohistochemical expression of PD-L1 was evaluated in 96 cases of CRC diagnosed between February 2022 and January 2024, using formalin-fixed paraffin-embedded (FFPE) tissue blocks. Statistical analysis was performed using SPSS version 25. The relationships between the PD-L1 expression and the clinicopathological parameters of CRC patients were determined using the chi-square test and Spearman's rank correlation. p < 0.05 was considered to be statistically significant. RESULTS: CRC showed a male: female ratio of 1:1.8, most occurred in the seventh decade and 54.17% were right-sided. Adenocarcinoma NOS accounted for 72.5%. The majority (n = 55, 57.3%) of the patients were diagnosed at an advanced stage. PD-L1 expression was observed in 86.46% of cases, significantly correlating with tumour Size (r = 0.263, p = 0.010*), histologic Grade (r = 0.446, p = 0.000*) and tumour Stage (r = 0.367, p = 0.000*). CONCLUSION: This study highlighted the high frequency of PD-L1 expression in CRC among black patients, with significant associations to clinicopathologic parameters. The findings suggest the potential benefit of PD-1/PD-L1 targeted therapies and emphasize the need for enhanced early detection and screening in Nigeria.