الفهرس 
Aim of the Work
Chapter 2: Tumor Microenvironment and Immune SurveillanceOnly 14 pages are availabe for public view
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Abstract
Among the most promising immune checkpoint molecules are the programmed death receptor (PD1), the programmed death ligand 1 (PD-L1) and cytotoxic T lymphocyte associated antigen-4 (CTLA–4) pathways. PD-L1 and CTLA-4 interactions act on suppressing T-cell response and inducing tumor immune escape. Therefore, they help to create a suitable tumor microenvironment that enables the tumor cells of continuous proliferation.
This selective retrospective study included 83 primary bladder carcinoma specimens from Egyptian patients retrieved from archival material of Pathology Department, Faculty of Medicine, Menoufia University spanning the period between 2017 and 2020.
Cystectomy cases were included in tissue microarray blocks and TURBT cases were used as single case blocks.
Hematoxylin and eosin (H&E) stained slides of the selected cases’ blocks were examined carefully to identify viable and representative areas of each sample. Tissue microarray technique was performed through sampling of three cores of representative areas of the tumor and stroma from each included specimen.
The collected cases included fifty five cases (66.3%) of radical cystectomy specimen (RC) and 28 cases (33.7%) were TURBT specimen
The Age of the patients ranged from 46 to 83 years old, with a mean±SD of 63. 06±7.12 and a median age of 63 years. Seventy four cases (89. 2%) were males, while 9 cases (10. 8%) were females.
Regarding the muscularis propria invasion: sixty cases (72.3%) were muscle invasive urinary bladder carcinoma (MIUBC), while 23 cases (27.7%) were non- muscle invasive urinary bladder carcino