Paraffin sections were heated at 80°C for 10 min, dewaxed in xylene, dehydrated by gradient alcohol, antigen retrieval was performed in EDTA solution for 2.5 min, 0.3% hydrogen peroxide for blocking endogenous peroxidase, and PD-L2 (clone D7U8C, Cell Signaling, USA, 1:100) was incubated overnight as a primary antibody. Secondary antibodies were incubated for 1 h, detected using 3, 3-diaminobenzidine tetrahydrochloride (DAB), counterstained with hematoxylin, and sealed with neutral gum. Immunohistochemical staining was independently assessed by two pathologists who were unaware of the patient’s diagnosis and clinical information. For PD-L2, according to tumor proportion score (TPS) and immune proportion score (IPS), membrane and cytoplasm staining were considered positive expression, divided into three grades: 0, negative: TPS/IPS <1%; 1, weakly positive: TPS/IPS: 1–49%; 2, strongly positive: TPS/IPS ≥50%.

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