Abstract
Introduction: Urothelial cancer poses a substantial medical and public health challenge in most parts of the world. Programmed Death Ligand 1 (PD-L1) is a cell surface glycoprotein that plays an important role in the suppression of cellular immune responses to tumour and is now emerging as a new target for immunotherapy. Aim: To examine PD-L1 expression in urothelial carcinoma and its relationship with various clinicopathological parameters. Materials and Methods: A retrospective analysis study was conducted on 50 cases of Urothelial Carcinomas diagnosed in Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, Punjab, India from January 2016 to January 2019. Detailed clinical data of the patients’ was collected and the analysis was undertaken between February 2019 and April 2019. Tissues were formalin fixed, paraffin embedded and were studied for histopathological grading after staining with haematoxylin and eosin. All cases were subjected to immunohistochemistry for PD-L1 expression. Chi-square test was used to assess the relationship between PD-L1 positivity and various clinicopathological parameters. A p-value <0.05 was considered as statistically significant. Results: A total of of 50 cases were included and 54% (27 cases out of total 50) were low grade cases. The maximum incidence was seen in 5th-7th decade of life with male preponderance. 27 cases out of the total 50 were low grade cases while the rest 46% (23 cases) were high grade. The PD-L1 positivity was observed in 19 cases (38%). The PD-L1 expression was significantly associated with high grade of tumour, increase in size of tumour and lamina propria invasion. Age, gender and muscle invasion however had no association with PD-L1 expression. Conclusion: The present study concluded that expression of PDL1 was significantly correlated with poorer clinicopathological variables including increasing size, higher grade and lamina propria invasion. PD-L1 positivity is therefore a bad prognostic marker
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