Programmed death-ligand 1 (PD-L1) expression in different sarcoma subtypes

Gizem Teoman; Elanur Karaman; Muhammet Salih Ayas; Ismail Saygin

doi:10.32322/jhsm.1902291

Programmed death-ligand 1 (PD-L1) expression in different sarcoma subtypes

Abstract

Aims: Sarcomas are rare and heterogeneous mesenchymal malignancies with diverse histological and molecular characteristics. Programmed death-ligand 1 (PD-L1) plays a key role in tumor immune evasion and may serve as a predictive biomarker for immune checkpoint inhibitor therapy. This study aimed to characterize PD-L1 expression across different sarcoma subtypes. Methods: A total of 54 sarcoma cases diagnosed between January 2020 and September 2025 at the Department of Medical Pathology, Karadeniz Technical University, were retrospectively analyzed. Subtypes included undifferentiated pleomorphic sarcoma (UPS, n=10), liposarcoma (well-differentiated, dedifferentiated, myxoid; n=17), osteosarcoma (n=7), leiomyosarcoma (n=7), myxofibrosarcoma (n=8), and fibromyxoid sarcoma (n=5). PD-L1 expression was assessed immunohistochemically using the validated monoclonal antibody clone 22C3 and quantified by the combined positive score (CPS). PD-L1 positivity was defined as CPS ≥1%. Results: Overall, 18 of 54 cases (33.3%) exhibited PD-L1 positivity. Expression varied across sarcoma subtypes, with relatively higher positivity rates observed in myxofibrosarcoma (4/8, 50%), leiomyosarcoma (3/7, 42.8%), osteosarcoma (3/7, 42.8%), and UPS (4/10, 25%). Lower PD-L1 expression was observed in fibromyxoid sarcoma (1/5, 20%) and liposarcoma (3/17, 17.6%). Among the liposarcoma subtypes, PD-L1 positivity was detected in one well-differentiated, one dedifferentiated, and one myxoid case. Conclusion: PD-L1 expression in sarcomas is heterogeneous and subtype-dependent. High-grade pleomorphic tumors, particularly myxofibrosarcomas, leiomyosarcomas, and osteosarcomas, appeared to demonstrate relatively more frequent PD-L1 positivity in this cohort. These findings provide insights into the immunobiology of sarcomas and support the potential rationale for future studies evaluating PD-1/PD-L1-targeted immunotherapies in PD-L1-expressing sarcoma subtypes.

Keywords

Ethical Statement

This study was conducted in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments. Ethical approval was obtained from the Karadeniz Technical University Faculty of Medicine Ethics Committee (Protocol No: 2025/336, Approval No: 24237859-90).

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Details

Primary Language

English

Subjects

Pathology

Journal Section

Research Article

Authors

Gizem Teoman ^*
0000-0001-5767-5007
Türkiye

Elanur Karaman
0000-0002-4264-8214
Türkiye

Muhammet Salih Ayas
0000-0002-7427-2223
Türkiye

Ismail Saygin
0000-0002-6013-6378
Türkiye

Publication Date

July 20, 2026

Submission Date

March 3, 2026

Acceptance Date

June 9, 2026

Published in Issue

Year 2026 Volume: 9 Number: 4

DOI

https://doi.org/10.32322/jhsm.1902291

IZ

https://izlik.org/JA22NZ77TE

Cite

RIS / Bibtex

APA

Teoman, G., Karaman, E., Ayas, M. S., & Saygin, I. (2026). Programmed death-ligand 1 (PD-L1) expression in different sarcoma subtypes. Journal of Health Sciences and Medicine, 9(4), 977-981. https://doi.org/10.32322/jhsm.1902291

AMA

1.Teoman G, Karaman E, Ayas MS, Saygin I. Programmed death-ligand 1 (PD-L1) expression in different sarcoma subtypes. J Health Sci Med / JHSM. 2026;9(4):977-981. doi:10.32322/jhsm.1902291

Chicago

Teoman, Gizem, Elanur Karaman, Muhammet Salih Ayas, and Ismail Saygin. 2026. “Programmed Death-Ligand 1 (PD-L1) Expression in Different Sarcoma Subtypes”. Journal of Health Sciences and Medicine 9 (4): 977-81. https://doi.org/10.32322/jhsm.1902291.

EndNote

Teoman G, Karaman E, Ayas MS, Saygin I (July 1, 2026) Programmed death-ligand 1 (PD-L1) expression in different sarcoma subtypes. Journal of Health Sciences and Medicine 9 4 977–981.

IEEE

[1]G. Teoman, E. Karaman, M. S. Ayas, and I. Saygin, “Programmed death-ligand 1 (PD-L1) expression in different sarcoma subtypes”, J Health Sci Med / JHSM, vol. 9, no. 4, pp. 977–981, July 2026, doi: 10.32322/jhsm.1902291.

ISNAD

Teoman, Gizem - Karaman, Elanur - Ayas, Muhammet Salih - Saygin, Ismail. “Programmed Death-Ligand 1 (PD-L1) Expression in Different Sarcoma Subtypes”. Journal of Health Sciences and Medicine 9/4 (July 1, 2026): 977-981. https://doi.org/10.32322/jhsm.1902291.

JAMA

1.Teoman G, Karaman E, Ayas MS, Saygin I. Programmed death-ligand 1 (PD-L1) expression in different sarcoma subtypes. J Health Sci Med / JHSM. 2026;9:977–981.

MLA

Teoman, Gizem, et al. “Programmed Death-Ligand 1 (PD-L1) Expression in Different Sarcoma Subtypes”. Journal of Health Sciences and Medicine, vol. 9, no. 4, July 2026, pp. 977-81, doi:10.32322/jhsm.1902291.

Vancouver

1.Gizem Teoman, Elanur Karaman, Muhammet Salih Ayas, Ismail Saygin. Programmed death-ligand 1 (PD-L1) expression in different sarcoma subtypes. J Health Sci Med / JHSM. 2026 Jul. 1;9(4):977-81. doi:10.32322/jhsm.1902291