Programmed Death Ligand 1 expression in Urothelial Carcinoma.A retrospective study in Duhok City-Iraq.


  • Zuzan Shawkat Mustafa Department of Histopathology, Central Lab, Duhok.
  • Gina James Keorges FICMS. Lecturer - Department of Pathology, College of Medicine, University of Duhok
  • Alaa Hani Raziq FICMS. Professor - Department of Pathology, College of Medicine, University of Duhok



Combined positive score, PDL-1, Urothelial cancer


Background and objective: Programmed death ligand-1 protein expression has been linked to the severity of Urothelial cancer. The objectives of this study were to evaluate the expression of programmed death-ligand 1 and determine the association with tumour grade, stage, type (Papillary and non papillary), muscle invasion, age, and gender.

Methods: This retrospective study was carried out from 2015 to 2022 on fifty-eight blocks belonging to patients with urothelial carcinoma, which were obtained from Duhok central lab and private laboratory. From each block, two sections were made; one of which was stained with Hematoxylin and Eosin for histological re-assessment and the other one for immunostaining for programmed death-ligand-1, which  was calculated in tumour cells and inflammatory cells regardless of staining intensity and then the combined positive score was determined and considered positive when is more than 10.

Result: This study included 58 cases of Urothelial carcinoma, Females represent 8 (13.79%)  cases and males 50 (86.21%) cases, with a female-to-male ratio of 1/6.25. No statistically significant association existed between the histological subtypes and gender. Combined positive score was positive  in (32.76%) of cases and negative (67.24%) cases. The association was significant with the stage of the tumor (p=0.03), muscle invasion (p=0.02) and highly significant with grade (p<0.001).

Conclusion: patients with urothelial carcinoma who have higher tumour grade, advanced stage and those who with muscle invasion can benefit from immune check point inhibitors.


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How to Cite

Mustafa , Z. S. ., Keorges, G. J. . . ., & Raziq, A. H. . . (2024). Programmed Death Ligand 1 expression in Urothelial Carcinoma.A retrospective study in Duhok City-Iraq. AMJ (Advanced Medical Journal) , 9(2), 54-63.