{"id":"https://openalex.org/W7225753549","doi":"https://doi.org/10.3389/fmed.2026.2002786","title":"Epithelioid trophoblastic tumor: a misdiagnosis-prone tumor with immune checkpoint expression and immunotherapeutic implications","display_name":"Epithelioid trophoblastic tumor: a misdiagnosis-prone tumor with immune checkpoint expression and immunotherapeutic implications","publication_year":2026,"publication_date":"2026-11-10","ids":{"openalex":"https://openalex.org/W7225753549","doi":"https://doi.org/10.3389/fmed.2026.2002786"},"language":"en","primary_location":{"id":"doi:10.3389/fmed.2026.2002786","doi":"https://doi.org/10.3389/fmed.2026.2002786","is_oa":true,"landing_page_url":"https://doi.org/10.3389/fmed.2026.2002786","pdf_url":null,"source":{"id":"https://openalex.org/S2597052008","display_name":"Frontiers in Medicine","issn_l":"2296-858X","issn":["2296-858X"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","norway-1","poland-70","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320527","host_organization_name":"Frontiers Media","host_organization_lineage":["https://openalex.org/P4310320527"],"host_organization_lineage_names":["Frontiers Media"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Frontiers in Medicine","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","doaj"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://doi.org/10.3389/fmed.2026.2002786","any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5161377539","display_name":"Miao Yu","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I131434179","display_name":"Nanjing University of Chinese Medicine","ror":"https://ror.org/04523zj19","country_code":"CN","type":"education","lineage":["https://openalex.org/I131434179"]},{"id":"https://openalex.org/I37461747","display_name":"Wuhan University","ror":"https://ror.org/033vjfk17","country_code":"CN","type":"education","lineage":["https://openalex.org/I37461747"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Miao Yu","raw_affiliation_strings":["Department of Pathology, Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine","Department of Pathology, School of Basic Medical Sciences, Wuhan University"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Pathology, Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine","institution_ids":["https://openalex.org/I131434179"]},{"raw_affiliation_string":"Department of Pathology, School of Basic Medical Sciences, Wuhan University","institution_ids":["https://openalex.org/I37461747"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5139670425","display_name":"Hongmei Lu","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I78978612","display_name":"Yangzhou University","ror":"https://ror.org/03tqb8s11","country_code":"CN","type":"education","lineage":["https://openalex.org/I78978612"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Hongmei Lu","raw_affiliation_strings":["Department of Pathology, Yangzhou Municipal Maternal and Child Health Hospital, Affiliated Hospital of Medical College of Yangzhou University"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Pathology, Yangzhou Municipal Maternal and Child Health Hospital, Affiliated Hospital of Medical College of Yangzhou University","institution_ids":["https://openalex.org/I78978612"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5056609698","display_name":"\u5f20\u9e3f\u83ba","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I131434179","display_name":"Nanjing University of Chinese Medicine","ror":"https://ror.org/04523zj19","country_code":"CN","type":"education","lineage":["https://openalex.org/I131434179"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Hongying Zhang","raw_affiliation_strings":["Department of Pathology, Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Pathology, Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine","institution_ids":["https://openalex.org/I131434179"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5161413418","display_name":"Qiongrong Chen","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210120234","display_name":"Zhongnan Hospital of Wuhan University","ror":"https://ror.org/01v5mqw79","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210120234"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Qiongrong Chen","raw_affiliation_strings":["Department of Pathology, Zhongnan Hospital of Wuhan University"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Pathology, Zhongnan Hospital of Wuhan University","institution_ids":["https://openalex.org/I4210120234"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5100752200","display_name":"Qin Shen","orcid":"https://orcid.org/0009-0002-8792-4128","observed_orcids":["https://orcid.org/0009-0002-8792-4128","https://orcid.org/0000-0002-2837-5299"]},"institutions":[{"id":"https://openalex.org/I131434179","display_name":"Nanjing University of Chinese Medicine","ror":"https://ror.org/04523zj19","country_code":"CN","type":"education","lineage":["https://openalex.org/I131434179"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Qin Shen","raw_affiliation_strings":["Department of Pathology, Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Pathology, Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine","institution_ids":["https://openalex.org/I131434179"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5161407595","display_name":"Honglei Chen","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I37461747","display_name":"Wuhan University","ror":"https://ror.org/033vjfk17","country_code":"CN","type":"education","lineage":["https://openalex.org/I37461747"]},{"id":"https://openalex.org/I4210120234","display_name":"Zhongnan Hospital of Wuhan University","ror":"https://ror.org/01v5mqw79","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210120234"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Honglei Chen","raw_affiliation_strings":["Department of Pathology, School of Basic Medical Sciences, Wuhan University","Department of Pathology, Zhongnan Hospital of Wuhan University"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Pathology, School of Basic Medical Sciences, Wuhan University","institution_ids":["https://openalex.org/I37461747"]},{"raw_affiliation_string":"Department of Pathology, Zhongnan Hospital of Wuhan University","institution_ids":["https://openalex.org/I4210120234"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":4,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":{"value":3150,"currency":"CHF","value_usd":3801},"apc_paid":{"value":3150,"currency":"CHF","value_usd":3801},"fwci":0.0,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":{"value":0.0,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"13","issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T12587","display_name":"Gestational Trophoblastic Disease Studies","score":0.9955999851226807,"subfield":{"id":"https://openalex.org/subfields/2729","display_name":"Obstetrics and Gynecology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T12587","display_name":"Gestational Trophoblastic Disease Studies","score":0.9955999851226807,"subfield":{"id":"https://openalex.org/subfields/2729","display_name":"Obstetrics and Gynecology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10158","display_name":"Cancer Immunotherapy and Biomarkers","score":0.0024999999441206455,"subfield":{"id":"https://openalex.org/subfields/2730","display_name":"Oncology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11069","display_name":"Testicular diseases and treatments","score":0.00039999998989515007,"subfield":{"id":"https://openalex.org/subfields/2746","display_name":"Surgery"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[],"concepts":[{"id":"https://openalex.org/C8891405","wikidata":"https://www.wikidata.org/wiki/Q1059","display_name":"Immune system","level":2,"score":0.5879999995231628},{"id":"https://openalex.org/C2777701055","wikidata":"https://www.wikidata.org/wiki/Q1427096","display_name":"Immunotherapy","level":3,"score":0.546500027179718},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.5461999773979187},{"id":"https://openalex.org/C204232928","wikidata":"https://www.wikidata.org/wiki/Q899285","display_name":"Immunohistochemistry","level":2,"score":0.5374000072479248},{"id":"https://openalex.org/C2781188995","wikidata":"https://www.wikidata.org/wiki/Q6934982","display_name":"Multiplex","level":2,"score":0.5169000029563904},{"id":"https://openalex.org/C2780851360","wikidata":"https://www.wikidata.org/wiki/Q21686041","display_name":"Immune checkpoint","level":4,"score":0.5013999938964844},{"id":"https://openalex.org/C502942594","wikidata":"https://www.wikidata.org/wiki/Q3421914","display_name":"Cancer research","level":1,"score":0.45899999141693115},{"id":"https://openalex.org/C2778236600","wikidata":"https://www.wikidata.org/wiki/Q592324","display_name":"Immunofluorescence","level":3,"score":0.4562000036239624},{"id":"https://openalex.org/C142724271","wikidata":"https://www.wikidata.org/wiki/Q7208","display_name":"Pathology","level":1,"score":0.4034000039100647},{"id":"https://openalex.org/C207886595","wikidata":"https://www.wikidata.org/wiki/Q1456138","display_name":"Pathological","level":2,"score":0.36410000920295715},{"id":"https://openalex.org/C159654299","wikidata":"https://www.wikidata.org/wiki/Q79460","display_name":"Antibody","level":2,"score":0.33489999175071716},{"id":"https://openalex.org/C2781053074","wikidata":"https://www.wikidata.org/wiki/Q21100639","display_name":"PD-L1","level":4,"score":0.2994999885559082},{"id":"https://openalex.org/C2776107976","wikidata":"https://www.wikidata.org/wiki/Q1786433","display_name":"Tumor microenvironment","level":3,"score":0.2962000072002411},{"id":"https://openalex.org/C2780030458","wikidata":"https://www.wikidata.org/wiki/Q7041828","display_name":"Nivolumab","level":4,"score":0.28769999742507935},{"id":"https://openalex.org/C118441373","wikidata":"https://www.wikidata.org/wiki/Q1347440","display_name":"Epithelioid cell","level":3,"score":0.28360000252723694},{"id":"https://openalex.org/C86803240","wikidata":"https://www.wikidata.org/wiki/Q420","display_name":"Biology","level":0,"score":0.2799000144004822},{"id":"https://openalex.org/C2779134260","wikidata":"https://www.wikidata.org/wiki/Q12136","display_name":"Disease","level":2,"score":0.26910001039505005},{"id":"https://openalex.org/C2780057760","wikidata":"https://www.wikidata.org/wiki/Q13896859","display_name":"Pembrolizumab","level":4,"score":0.2630999982357025},{"id":"https://openalex.org/C2778938455","wikidata":"https://www.wikidata.org/wiki/Q5038170","display_name":"Carcinosarcoma","level":3,"score":0.2612000107765198},{"id":"https://openalex.org/C2781113665","wikidata":"https://www.wikidata.org/wiki/Q5383708","display_name":"Epithelioid sarcoma","level":3,"score":0.25940001010894775},{"id":"https://openalex.org/C203014093","wikidata":"https://www.wikidata.org/wiki/Q101929","display_name":"Immunology","level":1,"score":0.2540999948978424},{"id":"https://openalex.org/C2777546739","wikidata":"https://www.wikidata.org/wiki/Q33525","display_name":"Carcinoma","level":2,"score":0.25220000743865967}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.3389/fmed.2026.2002786","doi":"https://doi.org/10.3389/fmed.2026.2002786","is_oa":true,"landing_page_url":"https://doi.org/10.3389/fmed.2026.2002786","pdf_url":null,"source":{"id":"https://openalex.org/S2597052008","display_name":"Frontiers in Medicine","issn_l":"2296-858X","issn":["2296-858X"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","norway-1","poland-70","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320527","host_organization_name":"Frontiers Media","host_organization_lineage":["https://openalex.org/P4310320527"],"host_organization_lineage_names":["Frontiers Media"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Frontiers in Medicine","raw_type":"journal-article"}],"best_oa_location":{"id":"doi:10.3389/fmed.2026.2002786","doi":"https://doi.org/10.3389/fmed.2026.2002786","is_oa":true,"landing_page_url":"https://doi.org/10.3389/fmed.2026.2002786","pdf_url":null,"source":{"id":"https://openalex.org/S2597052008","display_name":"Frontiers in Medicine","issn_l":"2296-858X","issn":["2296-858X"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","norway-1","poland-70","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320527","host_organization_name":"Frontiers Media","host_organization_lineage":["https://openalex.org/P4310320527"],"host_organization_lineage_names":["Frontiers Media"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Frontiers in Medicine","raw_type":"journal-article"},"sustainable_development_goals":[],"study_designs":[],"awards":[],"funders":[],"has_content":{"pdf":false,"grobid_xml":false},"content_urls":null,"referenced_works_count":20,"referenced_works":["https://openalex.org/W2012970118","https://openalex.org/W2024047645","https://openalex.org/W2068542046","https://openalex.org/W2316025290","https://openalex.org/W2418421002","https://openalex.org/W2735385128","https://openalex.org/W2769809456","https://openalex.org/W2806261611","https://openalex.org/W2914388287","https://openalex.org/W2942215178","https://openalex.org/W3176089420","https://openalex.org/W3199414911","https://openalex.org/W4387045400","https://openalex.org/W4387950106","https://openalex.org/W4391378149","https://openalex.org/W4400274010","https://openalex.org/W4408090870","https://openalex.org/W4415260878","https://openalex.org/W7127080084","https://openalex.org/W7164402960"],"related_works":[],"abstract_inverted_index":{"Background/Objectives":[0],"Epithelioid":[1],"trophoblastic":[2,11],"tumor":[3,119,152],"(ETT)":[4],"is":[5,14,32],"the":[6,124],"rarest":[7],"form":[8],"of":[9,145,166,194],"gestational":[10],"neoplasia":[12],"and":[13,28,36,64,71,113,148,177],"highly":[15],"prone":[16],"to":[17,20,74,110,131,160],"misdiagnosis":[18],"due":[19],"its":[21],"morphological":[22],"overlap":[23],"with":[24,93,121,135,154],"squamous":[25],"cell":[26],"carcinoma":[27],"epithelioid":[29],"leiomyosarcoma.":[30],"It":[31],"also":[33],"relatively":[34],"chemoresistant,":[35],"effective":[37],"therapies":[38],"for":[39,57,182],"recurrent":[40],"or":[41],"metastatic":[42],"disease":[43],"remain":[44],"lacking.":[45],"Methods":[46],"We":[47],"retrospectively":[48],"analyzed":[49],"five":[50,90],"ETT":[51,91],"cases,":[52,92,163],"integrating":[53],"clinicopathological":[54],"review,":[55],"immunohistochemistry":[56],"diagnostic":[58,103,175],"markers":[59],"(GATA-3,":[60],"p63,":[61],"p40,":[62],"p16)":[63],"immune":[65,133,168,187],"checkpoints":[66],"(PD-L1,":[67],"PD-L2,":[68],"B7-H3,":[69,146],"VISTA),":[70],"multiplex":[72],"immunofluorescence":[73,141],"resolve":[75],"spatial":[76],"co-expression.":[77],"Results":[78],"Four":[79],"cases":[80],"were":[81,115],"initially":[82],"misdiagnosed.":[83],"p40":[84],"was":[85,128],"focally":[86],"positive":[87],"in":[88,97,184,198],"all":[89],"diffuse":[94],"strong":[95],"positivity":[96],"SCC":[98],"controls,":[99],"highlighting":[100],"a":[101,179],"potential":[102],"pitfall.":[104],"PD-L1":[105],"CPS":[106],"ranged":[107],"from":[108,158],"10":[109],"60;":[111],"PD-L2":[112,149],"B7-H3":[114,122],"predominantly":[116],"expressed":[117],"on":[118,150],"cells,":[120,134,153],"showing":[123],"highest":[125],"positivity.":[126],"VISTA":[127],"largely":[129],"confined":[130],"CD3+":[132],"only":[136],"rare":[137],"tumor-cell":[138],"expression.":[139],"Multiplex":[140],"revealed":[142],"frequent":[143],"co-expression":[144,165,189],"PD-L1,":[147],"GATA-3+":[151],"triple-positive":[155],"cells":[156],"ranging":[157],"5%":[159],"35%":[161],"across":[162],"indicating":[164],"multiple":[167],"checkpoint":[169,188],"molecules.A":[170],"Conclusions":[171],"These":[172],"findings":[173],"refine":[174],"awareness":[176],"provide":[178],"pathological":[180],"rationale":[181],"immunotherapy":[183],"ETT.":[185],"The":[186],"pattern":[190],"supports":[191],"further":[192],"evaluation":[193],"combination":[195],"immunotherapeutic":[196],"strategies":[197],"this":[199],"rare,":[200],"chemoresistant":[201],"malignancy.":[202]},"counts_by_year":[],"updated_date":"2026-11-11T12:16:26.678958","created_date":"2026-11-11T00:00:00"}