Hubungan Ekspresi Imunohistokimia Program Cell Death Ligand 1 (PD-L1) dengan Grading The International Society of Urological Pathology (ISUP) pada Adenocarcinoma Prostate di Rumah Sakit Pendidikan Prof. Chairuddin Panusunan Lubis Medan

Abstract

Background Diffuse astrocytic tumor (DAT) is an infiltrative diffuse astrocytoma tumor accompaniedbymolecular parameters in the form of the presence or absence of isocitrate dehydrogenase(IDH)gene mutations. DAT categories without IDH gene mutation testing are classified as Not Otherwise Specified (NOS). Ki-67 is a marker for assessing TAD proliferation, therebyenabling the evaluation of TAD grade. TAD behavior is influenced by its proliferationcapacity and the presence of a tumor microenvironment. The tumor microenvironment factorPD-L1 influences TAD behavior and enables the development of targeted therapy inTADcases. This study aims to analyze the relationship between PD-L1 and Ki-67 immunoexpression in TAD histopathology grades. Methods A cross-sectional study of 30 paraffin blocks of TAD NOS cases from2014 to 2018at theDepartment of Anatomical Pathology, Dr. Hasan Sadikin General Hospital, Bandung. Thesample consisted of 15 grade II cases, 7 grade III cases, and 8 grade IV cases that underwent immunohistochemical staining with GFAP, PD-L1, and Ki-67. PD-L1 immunoexpressionwasassessed using the histoscore method. Ki-67 was assessed based on its distribution, namely<10% and ≥10%. PD-L1 and Ki-67 immunoexpression with histopathological grade inTADwere statistically analyzed using the Kolmogorov Smirnov test, while the relationshipbetween PD-L1 immunoexpression and Ki-67 immunoexpression was assessed usingthechi-square test. Results There was a significant correlation between PD-L1 immunoexpression and histopathological grade in TAD (p=0.005). There was a significant correlation between Ki-67 immunoexpression and histopathological grade in TAD and with PD-L1 (p=0.001 andp=0.010). Conclusion PD-L1 immunostaining and proliferation rate influence the grade of DTA. The proliferationrate of DTA is influenced by PD-L1, so in this study, PD-L1 and Ki-67 can be usedas oneofthe prognostic markers.