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Primary adenocarcinoma of the bladder lacks mismatch repair deficiency and demonstrates PD-L1 expression in tumor-infiltrating immune cells, with implications in both diagnosis and therapeutics

Human Pathology Nov 08, 2019

Jones D, et al. - In this study, using immunohistochemistry, experts investigated PD-L1 expression in 56 cases of bladder adenocarcinoma and mismatch repair protein expression in 42 cases of bladder adenocarcinoma. In all cases of bladder adenocarcinoma, compared with 19% of advanced colorectal adenocarcinoma being mismatch repair deficient, mismatch repair protein expression was consistently intact. The finding designates that mismatch repair proteins could be combined with β-catenin and GATA-3 in order to generate an immunostaining panel which, along with clinical studies, could help in differentiating bladder adenocarcinoma from secondary involvement by colorectal carcinoma. In tumor cells, about 4% of cases were discovered to overexpress PD-L1 while nearly a third of cases were seen to exhibit PD-L1 expression in tumor-infiltrating immune cells. Thus, these outcomes designate hypermutators are possible rare in bladder adenocarcinoma, however, 20–30% of the people could be suitable for immune checkpoint blockade therapy.
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