Objective      To determine the expression levels of apurinic/apyrimidinic endonuclease 1 (APE1) and programmed death ligand-1 (PD-L1) in early stage cervical squamous cell carcinoma and explore their clinical significance. Methods      Immunohistochemical staining was applied to detect the expression of APE1 and PD-L1 in 64 samples of early stage cervical squamous cell carcinoma. The correlation of their expression with clinicopathological features of the patients with cervical cancer was analyzed. Spearman rank correlation analysis was used to study the correlation between APE1 expression and PD-L1expression

Kaplan-Meier survival analysis to evaluate the impact of APE1 and PD-L1 expression on postoperative survival of the patients

and Cox univariate and multivariate prognostic analysis to explore the prognostic factors of the patients. Results      The positive rate of APE1 was 70.31%

and that of PD-L1 was 60.18% in the 64 samples. The expression of PD-L1 was closely correlated with the stage of the International Federation of Gynecology and Obstetrics (FIGO) and lymphatic metastasis (P0.05)

and the expression of APE1 expression was closely correlated with lymphatic metastasis (P=0.038). Spearman rank correlation analysis indicated that the expression of APE1 was positively correlated with that of PDL1 (r2=0.347

P=0.005)

and their co-expression was closely correlated with lymphatic metastasis

and the survival time was obviously shorter in those with co-expression than those with single expression (P0.05). Multivariate Cox analysis revealed that the expression of APE1 and lymphatic metastasis were independent risk factors for the prognosis of the patients with early stage cervical squamous cell carcinoma (Hazard ratio=16.187

P=0.01; Hazard ratio=27.340

P0.001). Conclusion      Combinatorial detection of APE1 and PD-L1 is of potential value for the prognosis evaluation of early stage cervical squamous cell carcinoma.