Expression of B7–H4 in endometrial cancer and its impact on patients’ prognosis

Objectives: The aim of the study was to evaluate the B7–H4 expression in endometrial cancer cells and to investigate its relationship with patient prognosis and clinicopathological features of the disease. Material and methods: We performed a single-center, retrospective cohort study that included endometrial cancer patients treated between 2012 and 2019. B7–H4 expression in specimens obtained from 63 patients was examined by immunohistochemical staining. The evaluation of B7H4 immunoreactivity was assessed using Immunoreactivity Scoring (IRS) system. Results: B7–H4 reactivity was observed in all, except one, endometrial cancer patients (98%). Staining intensity: no reaction in one case, weak in 16 (24%) patients, moderate in 25 (37%), and strong in 22 (35%). Twenty-nine (46%) patients showed B7–H4 immunoreactivity in more than 60% of cells, while, in 18 (29%) cases and 16 (25%) patients, the percentages were 30–60% and < 30% respectively. Median IRS was 2 (range 0–6). We found a significantly worse overall survival (OS) rate for patients with high versus low B7–H4 IRS (p = 0.03), however, in multivariate analysis, the difference in patient survival was close to the significance level (p = 0.052). B7–H4 expression was not related to histopathological type of the tumor, tumor grade, lymph node metastases, or the FIGO stage of the disease. Conclusions: Our result suggests that B7–H4 expression might be a useful prognostic factor in endometrial cancer