College of Medicine, University of Babylon Discusses a Research Study as Part of the Requirements for the Iraqi Board Fellowship in Pathology (Histopathology) The College of Medicine at the University of Babylon witnessed the discussion of a research study submitted as part of the requirements for obtaining the Iraqi Board Fellowship in Pathology (Histopathology) by the researcher Mustafa Kazem Aboud. The study was entitled: “Evaluation of the Significance of Immunohistochemical Expression of PD-L1 in Prostate Cancer and Its Association with Clinical and Pathological Parameters.” The research was conducted under the supervision of Prof. Dr. Haider Abdul-Ridha Akhiyoush Al-Khafaji. The importance of this study stems from the fact that prostate cancer is the second most common cancer and the fifth leading cause of cancer-related death among men worldwide. The most common type of prostate cancer is adenocarcinoma. It has been established that the expression of programmed cell death ligand-1 (PD-L1) is associated with poor prognosis in various human malignancies. However, available data regarding the prognostic and clinicopathological significance of PD-L1 expression in prostate cancer are limited, and the therapeutic impact of anti-PD-1/PD-L1 therapy remains controversial. This retrospective cross-sectional study was conducted at the Babylon Training Center for Pathology at Al-Hilla Teaching Hospital and extended from December 2024 to December 2025. The study was carried out on formalin-fixed, paraffin-embedded surgical specimens and included 50 cases of prostatic adenocarcinoma. Immunohistochemical expression of PD-L1 was statistically analyzed and classified according to the Combined Positive Score (CPS) system in all cases, and correlated with age, preoperative prostate-specific antigen (PSA) level, lymphovascular invasion, perineural invasion, and histopathological tumor grade. The study included 50 cases of prostatic adenocarcinoma, of which 44.0% showed positive PD-L1 expression. A significant positive association was demonstrated between PD-L1 expression and tumor grade, lymphovascular invasion, and perineural invasion. Immunohistochemical expression of PD-L1 was clearly observed in cases of prostatic adenocarcinoma. The expression was found to be dependent on histological pattern, increasing with loss of differentiation and higher Gleason grades. It was also significantly associated with perineural invasion and lymphovascular invasion, and consequently with tumor aggressiveness. These findings support the potential use of PD-L1 as a prognostic and predictive marker. In contrast, patient age and preoperative PSA level were not associated with PD-L1 expression.
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