WORLD JOURNAL OF ADVANCE
HEALTHCARE RESEARCH

*Maryam Dawood Essa M.B.Ch.B

ABSTRACT

Background: Urothelial carcinoma (UC) is one of the important causes of cancer related morbidity and mortality. It comprises approximately 90% of all primary cancer of bladder. Recently, new treatment options for patients with UC with associated biomarkers have been approved. Specifically, programmed death?ligand 1/programmed cell death protein 1 (PD?L1/PD?1) immunotherapies have been approved in patients with locally advanced or metastatic UC with PD?L1 expression. Programmed cell death ligand 1 (PD-L1) is a cell surface glycoprotein that belongs to the B7/CD28 co-stimulatory factor superfamily. It functions as an inhibitor of the immune response through promoting T-cell apoptosis by either binding to programmed cell death-1 (PD-1) receptor, or a putative non-PD-1 receptor on the surface of T lymphocytes. Similar to self-antigen recognition, cancer cell can escape immune surveillance by upregulating PD-L1. Moreover, the PD-1/PD-L1 signaling axis may induce immune inhibitory/exhaustion signaling of activated T cells, and thus significantly impair the anti-tumor immune response, Therefore, it is hypothesized that blockade of the PD-1/PD-L1 pathway may restore the native anti-tumor function of T cells and facilitate tumor regression. The aim of this study: Investigating the PDL1 immunohistochemical expression in Iraqi patients with invasive urothelial carcinoma and its correlation with the age, gender and lymphovascular invasion. Materials and Methods: This cross sectional study includes 50 bladder samples, collected between January 2022 and June 2024. All the cases was histopathologically evaluated and immunohistochemically stained for PDL 1. The samples of bladder (invasive urothelial carcinoma) were collected from Safeer al imam hussein Hospital, Immam-Hussein Medical City and private pathology laboratories in karbala. Results: In this study, 50 sample of invasive urothelial carcinoma were enrolled and all of them were of high grade, so these result may indicate that invasiveness associated with high grade and tumor cells PDL1 expression may be valuable for evaluation of tumor aggressiveness. Our result show male predominance (41 patient, 82% of the samples) and an age range from 42 to 94 years. The PDL1 was expressed in 60% of the cases, and 33 of cases show positive LVI 18 cases of them show positive PDL1 expression (54.5%). Conclusion: The high prevalence positivity of PDL1 irrespective of age and gender can aid and points to the possible use of immunotherapeutic agents in all sex and age groups.