Immunohistochemical expression of immune check point protein PDL-1 in hepatocellular carcinoma denotes its prognostic significance and association with survival.

This study was designed to evaluate the immunohistochemical expression of programmed death ligand-1 (PD-L1) in tumor cells (TCs) and tumor-infiltrating immune cells (TICs) in hepatocellular carcinoma (HCC) and to correlate its expression with clinicopathological parameters. Seventy-two formalin-fixed paraffin-embedded blocks of HCC were collected. The data were collected from the patients' records. The blocks were stained with hematoxylin and eosin. Additionally, they were immunostained with PD-L1. Membranous staining was considered positive expression including the entire membrane or part of it ± cytoplasmic staining, and the percentage of total cancer cells ≥ 5% was evaluated as positive staining for TCs. The TICs were considered positive if they expressed membranous ± cytoplasmic staining of PD-L1 ≥ 1%. Of the total cases, 34.7% expressed PD-L1 positively in TCs and 15.3% expressed PD-L1 positively in TICs. Significant associations were observed between PD-L1 expression in TCs and tumor grade, capsular and/or vascular invasion, tumor stage, nodal metastasis, and the expression of PD-L1 in paracancerous tissue. The cases that positively expressed PD-L1 exhibited reduced overall survival (OS). PD-L1 was expressed in HCC TCs and TICs. Its expression in TCs was associated with higher HCC grades, advanced stages, capsular and/or vascular invasion, and nodal metastasis, and cases that expressed PD-L1 displayed reduced OS. Therefore, PD-L1 might serve as a poor prognostic indicator and a tumor immunotherapy target.

Immunohistochemical Expression of Programmed Death Ligand-1 (PDL-1) in Colorectal carcinoma and Its Correlation with Stromal Tumor Infiltrating Lymphocytes.

OBJECTIVES: Detection of Immunohistochemical (IHC) expression of PDL-1 by tumor cells and stromal tumor infiltrating lymphocytes (TILs) in colorectal carcinoma, to investigate the possibility of using it as a targeted therapy, as well as, correlation of this expression with the clinico-pathologic parameters of the tumors. MATERIALS AND METHODS: Colorectal tissue sections were collected from 60 colectomy specimens were taken from Kasr El Ainy Hospital, Faculty of Medicine, Cairo University. Exclusion criteria included cases with missing data and cases who received chemotherapy or radiotherapy. IHC expression of PDL-1 was investigated in tumor cells (T) and stromal TILs separately. PDL-1 positivity was defined as PDL-1 expression on ≥ 5% of membranous positive cell staining of any intensity. RESULTS: PDL-1 (T) expression was detected in 25% of cases and showed statistically significant correlation with higher tumor grade and right sided colon tumors (P value < 0.05). PD-L1 stromal TILs expression was detected in 38.3 % of cases. Insignificant statistical relation between Stromal TILs PDL-1 expression and the tumor extent (T) was detected (P value = 0.07), however, the expression of PDL-1 in lymphocytes was inversely proportional to the tumor extent (invasion). There were linear relation between PDL-1 expression stromal (TILs) (33.3%) and PDL-1 expression in tumor cells (28.2%) and positive lympho-vascular invasion but it was statistically insignificant (P value = 0.4 and 0.2 respectively). Despite there were no statistical relation between either PDL-1 (T) and PDL-stromal TILS and Perineural invasion (P value =1 and 0.5) but inverse relation was noticed with more PDL-1 expression in tumor cells (24.5%) and TILS (40.8%) with negative Perineural invasion. CONCLUSION: Our results supported PDL-1 expression in CRC by both TC and TILs, with higher expression in subset of tumors that are high grade highlighting them as candidates for anti- PD-1/PDL-1 therapy.
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First insight into the genetic population structure of Mycobacterium tuberculosis isolated from pulmonary tuberculosis patients in Egypt.

The present study aimed to assess the population structure of Mycobacterium tuberculosis (MTB) isolates from Egypt. A total of 230 MTB isolates were analysed using spoligotyping, large sequence polymorphism (LSPs), mycobacterial interspersed repetitive unit-variable number tandem repeat (MIRU-VNTR) typing and multi-locus sequence typing (MLST). The majority of isolates (93.0%) belonged to lineage 4, including 44.3, 13.4 and 10.8% of the ill-defined T clade, LAM and Haarlem families, respectively, and lineage 3 was identified in 7.0% of the isolates. MIRU-VNTRs typing allowed efficient discrimination of the spoligotype-defined clusters, including spoligo-international types (SIT) 53, 34, and 4, into 56 patterns, including 13 clusters and 43 unique patterns. A new SNP at position 311614 was identified in all six isolates to form the biggest MIRU-VNTR cluster, which suggested a recent clonal expansion. This SNP could possibly be used as a genetic marker for robust discriminations of Egyptian MTB isolates belonging to SIT53. The combination of spoligotyping, 12 MIRU-VNTRs loci and MLST provided insight into the genetic diversity and transmission dynamics of the Egyptian MTB genotypes and could be a key to implementation of effective control measures by public health authorities.