The Value Of PD-L1 Immunohistochemical Expression In Egyptian Urinary Bladder Carcinoma Patients.

Objectives: To evaluate programmed death-ligand 1 immunohistochemical expression in the available variants of urinary bladder carcinoma, and to correlate its expression with the available clinicopathological features. Method: The retrospective study was conducted at the Faculty of Medicine, Kafrelsheikh University, Egypt, from February 2020 to April 2021, and comprised formalin-fixed and paraffin-embedded specimens of urinary bladder carcinoma belonging to patients who had no history of radiotherapy or chemotherapy. Immunohistochemicalstaining of all cases was done using anti-programmed death-ligand 1 antibody. Data was analysed using SPSS 20. RESULTS: Of the 70 specimens, 58(82.86%) had been obtained through transurethral resection of bladder tumours and 12(17.14%) through radical cystectomy. Also, 53(75.7%) specimens belonged to males and 27(24.3%) to females. The age of the cases ranged 34-83 years, and 59(84.3%) were aged ≥45 years. There were 27(38.6%) noninvasive bladder tumours and 43(61.4%) were infiltrating bladder carcinomas. Positive programmed death-ligand 1 expression was detected in 42(60%) cases. Age, gender and histopathological type were not significantly associated with the expression of programmed death-ligand 1. CONCLUSIONS: Programmed death-ligand 1 could be considered a predictive marker for aggressive bladder carcinoma and its immunohistochemical expression may aid in identifying selective patients for targeted immunotherapy.

Roles of Combined Glypican-3 and Glutamine Synthetase in Differential Diagnosis of Hepatocellular Lesions.

BACKGROUND: Hepatocellular carcinoma (HCC) is the fifth most prevalent cancer and thirdly leading cause of cancer-related death worldwide. The estimated risk of hepatocellular carcinoma is 15 to 20 times as high among persons infected with HCV as it is among those who are not infected, with most of the excess risk limited to those with advanced hepatic fibrosis or cirrhosis. Glypican3 (GPC3) plays a key role in relation to signaling with growth factors, regulating the proliferative activity of cancer cells. Glutamine synthetase (GS) catalyzes the synthesis of glutamine from glutamate and ammonia in the mammalian liver. GS was suggested as a specific marker for tracing cell lineage relationships during hepatocarcinogenesis. In normal liver, GS expression is seen in pericentral hepatocytes, but not by midzonal or periportal hepatocytes. In HCC, strong and diffuse GS expression in seen in tumor cells. RESULTS: Glypican3 immunopositvity was highly specific and sensitive indicator for hepatocellular carcinoma as well as glutamine synthetase which was found to be a sensitive and specific indicator for development of hepatocellular carcinoma when compared to cirrhosis, liver cell dyspalsia and metastatic carcinomas. Statistical analysis revealed a significant association between GPC3 and GS with tumor size (P=0.003, p=0.006, respectively). Diffuse staining significantly associated with large tumor size while, focal and mixed staining was detected more with small tumor size. Studying the relation with tumor grade also revealed significant association between diffuse GPC3 and GS staining with high tumor grade. Diffuse staining was detected in 91.7% and 100% respectively of poorly differentiated specimens and only in 33.3% and 22.2% of well differentiated specimens. CONCLUSIONS: While using GPC3 and GS to screen for premalignant hepatic lesions remains controversial, our data suggest that GPC3 and GS may be a reliable diagnostic immunomarkers to distinguish HCC from benign hepatocellular lesions. However, negative immunostaining should not exclude the diagnosis of HCC.