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Abstract：
Background: Programmed death-ligand 1 (PD-L1) expression has been recognized as a potential biomarker for various cancers, yet its diagnostic and prognostic significance in urothelial bladder cancer (BCa) requires further investigation. Methods: In this prospective single-center study, we aimed to assess the feasibility and diagnostic adequacy of PD-L1 expression analysis using cytoinclusion in BCa patients. We enrolled consecutive patients undergoing endoscopic transurethral resection of bladder tumor (TURBT), repeat TURBT, or robot-assisted radical cystectomy. Urinary and tissue specimens were collected from these patients for cytoinclusion and histopathological analysis to evaluate PD-L1 expression. Results: Out of 29 patients, PD-L1 expression was detected from cytoinclusion in 42.8% (3 out of 7), 10% (1 out of 10), and 66.8% (8 out of 12) of patients with negative/papilloma, low-grade, and high-grade tumors, respectively. Conversely, histopathological analysis identified PD-L1 expression in 57.2% (4 out of 7), 30% (3 out of 10), and 83.3% (10 out of 12) of patients with negative/papilloma, low-grade, and high-grade tumors, respectively. The diagnostic concordance between cytoinclusion and histopathology was 85.7%, 80%, and 83.3% in patients with negative/papilloma, low-grade, and high-grade tumors, respectively. Conclusions: Our study underscores the promise of cytoinclusion as a minimally invasive method for quantifying urinary PD-L1 percentages. This approach could serve as both a potential prognostic and diagnostic indicator, easily obtainable from urine samples. Standardizing this technique could facilitate its widespread use as a valuable tool.
摘要：
背景：程序性死亡配体1（PD-L1）的表达已被认为是各种癌症的潜在生物标志物。但其在膀胱尿路上皮癌(BCa)中的诊断和预后意义仍需进一步研究.方法：在这项前瞻性单中心研究中，我们旨在评估BCa患者中使用细胞包涵体进行PD-L1表达分析的可行性和诊断性。我们招募了连续接受内镜下经尿道膀胱肿瘤电切术（TURBT）的患者，重复TURBT,或机器人辅助根治性膀胱切除术。从这些患者收集尿液和组织标本用于细胞包合和组织病理学分析以评估PD-L1表达。结果:29例患者中,从细胞内含物中检测到PD-L1表达占42.8％（7个中的3个），10%（10个中的1个），66.8%(12人中有8人)的阴性/乳头状瘤患者，低档,和高级别肿瘤，分别。相反，组织病理学分析确定了57.2%的PD-L1表达(7个中的4个)，30％（10个中的3个），83.3%(12人中有10人)的阴性/乳头状瘤患者，低档,和高级别肿瘤，分别。细胞包涵体和组织病理学之间的诊断一致性为85.7％，80%,阴性/乳头状瘤患者占83.3%，低档,和高级别肿瘤，分别。结论：我们的研究强调了细胞内含物作为定量尿PD-L1百分比的微创方法的前景。这种方法可以作为潜在的预后和诊断指标，很容易从尿液样本中获得。标准化该技术可以促进其作为有价值的工具的广泛使用。
