Evaluation of PD-L1 Expression in Colorectal Carcinomas by Comparing Scoring Methods and Their Significance in Relation to Clinicopathologic Parameters.

BACKGROUND: This study aims to evaluate PD-L1 expression in colorectal carcinomas (CRCs) by using the tumor proportion score (TPS) and the combined positive score (CPS), and to investigate whether there is a correlation with clinicopathologic features. METHODS: A cross-sectional study was conducted that included samples from patients with colorectal adenocarcinoma treated with colon resection and rectal resection after neoadjuvant radio- and chemotherapy at the Department of Abdominal Surgery at Pozega Hospital in the period from 2017 to 2022. The study included 102 tumor tissue samples from patients after resection and the pathohistological diagnosis of adenocarcinoma. RESULTS: In our study, the PD-L1 positivity rate after the TPS was 42 (41%) samples, and after the CPS, 97 (95%) of them (p < 0.001). The positive expression of PD-L1 in tumor cells using the TPS method showed a statistically significant association with adenocarcinoma (TPS ≥ 10-50% and ≥50%). There were significantly more that were moderately differentiated, with TPS ≥ 50%, and those poorly differentiated had values ≥ 10-50%. There were significantly more patients with a status of more than one positive lymph node with TPS values ≥ 10-50%. Patients without metastases in the lymph nodes are significantly more likely to have CPS values > 50%, compared with other lymph node statuses. CONCLUSIONS: These results suggest that the total number of PD-L1-expressing cells, including tumor and immune cells, is a more sensitive biomarker than the number of PD-L1-expressing tumor cells alone in CRC.

Preventive health care for pre-school children in Croatia: ongoing trends from 1995 to 2012.

In Croatia, primary health care for pre-school children is organized by pediatricians (PPs) for children in urban and family doctors (FDs) for children in remote areas. This study was undertaken with the aim to determine the trends in preventive activities (general, targeting, and control check-ups and total visits) in both services (FDs, PPs), between 1995 and 2012. The main adapt source was the Croatian Health Service Yearbooks. According to the results, the number and the structure of preventive activities performed by PPs are relatively stable, while those performed by FDs decreased rapidly, primarily because the number of children under the care decreased. It is probable in relations with the regulations to direct the children to PPs and not to the FDs. The average numbers of all preventive activities are under the optimum. There are many similarities between FDs' and PPs', some activities were frequently performed by FDs and others by PPs'.