Clinical Study On The Relationship Between The Expression Of Programmed Death Ligand-1 And Tumor Grade And Clinical Stage Of Upper Urothelial Carcinoma

Backgroud: UTUC is a relatively rare but aggressive high malignant tumor.The clinical pathological characteristics are different from bladder urothelial carcinoma,so the treatments are also various.Radical renal resection of the ureter and bladder cuff resection has been the main method of the treatment.Chemotherapy has definite therapeutic effect in adjuvant therapy,which has problems in tolerance.With the development of immunotherapy,various immunomodifiers aimed to PD-L1 have been played a more important role in the treatment of UTUC.So it is necessary for us to know the expression of PD-L1 in UTUC.But the clinical tests designed for UTUC are less.Target : To analyze the relationship between the expression of programmed-death ligand-1(PD-L1)and the clinicopathological features of upper tract urothelial carcinoma(UTUC).Methods: This study involved the clinical data of 176 patients receiving RNU in the Second Xiang Ya Hospital of Central South University from 2015 to 2021.Immunohistochemistry was used to detect the expression of PD-L1 in the pathological specimen.5% was used as the cut-off to judge the positive or negative of PD-L1.The positive rate of PDL1 in patients with UTUC was estimated.The Chi-square test was used to analyze the relationship between the expression of PD-L1 and the tumor grade and pathological period of UTUC.Results:The average age was 65 years old.There are 105 patients with positive PD-L1(59.7%),and 71 patients with negative PD-L1(40.3%).Chi-square test showed that the positive PD-L1 expression was related to the high-grade tumor(P=0.002).The PD-L1 expression was related to the pathologic stage(P=0.007).Conclusion: The positive PD-L1 expression was related to higher grade and pathologic stage,which suggested that it is possible to use PDL1 as one of the biomark of the prognosis and immunotherapy of UTUC.