Supplementary file 1_Reduced Nectin-4 expression in lymph node metastases of penile squamous cell carcinoma: a paired primary–metastatic analysis.docx

Objective<p>To evaluate Nectin-4 expression in primary and matched metastatic penile squamous cell carcinoma (PSCC) lesions and to assess its associations with clinicopathological features and survival outcomes.</p>Methods<p>We analyzed 123 patients with pathologically confirmed PSCC treated at our hospital between 2018 and 2024. Nectin-4 expression was assessed by immunohistochemistry using the H-score (0-300) in primary tumors and 30 matched lymph node metastases, and associations with pathological features, paired primary-metastatic differences, and survival outcomes were analyzed.</p>Results<p>Nectin-4 was widely expressed in PSCC.

Higher Nectin-4 expression was observed in less aggressive tumors. Expression was higher in T1 than in T2 stage (95% CI 19.10-79.28; P < 0.01) and decreased from G1 to G3, with significant differences between G1 and G2 (95% CI 0.39-63.83; P = 0.047) and between G1 and G3 (95% CI 24.41-170.43; P = 0.009). Expression in primary tumors was not significantly associated with nodal status.