{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T11:12:35Z","timestamp":1788433955846,"version":"build-2803163510"},"reference-count":56,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Int. J. Mol. Sci.","IJMS"],"abstract":"<jats:p>Programmed death-ligand 1 (PD-L1) expression in Grade Group 1 (GG1) prostate carcinoma biopsies has not been established as a marker of pathological upgrading at radical prostatectomy (RP). This two-center retrospective case\u2013control study included 172 men with GG1 carcinoma in the biopsy closest to RP: all 86 patients upgraded to GG2 and 86 randomly selected non-upgraded controls from 126 eligible GG1 patients. PD-L1 was assessed with the SP263 clone using the combined positive score (CPS), with CPS \u2265 1 predefined before outcome comparison. CPS \u2265 1 occurred in 36\/86 upgraded cases (41.9%) and 18\/86 controls (20.9%; unadjusted odds ratio [OR], 2.72; 95% confidence interval [CI], 1.39\u20135.33; p = 0.005). After adjustment for serum prostate-specific antigen, positive-core count, Prostate Imaging Reporting and Data System category, and center, CPS \u2265 1 remained associated with upgrading (adjusted OR, 2.91; 95% CI, 1.47\u20135.97; p = 0.003). A Firth bias-reduced sensitivity model including digital rectal examination yielded a similar CPS estimate. Biopsy CPS \u2265 1 was associated with biopsy\u2013RP grade discordance, but the study does not establish an optimal cutoff, predictive performance, or clinical utility. Prospective multicenter validation, including active-surveillance outcomes, is required.<\/jats:p>","DOI":"10.3390\/ijms27177878","type":"journal-article","created":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T10:10:33Z","timestamp":1788430233000},"page":"7878","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association Between Biopsy PD-L1 Combined Positive Score and Pathological Upgrading at Radical Prostatectomy in Grade Group 1 Prostate Cancer: A Retrospective Study"],"prefix":"10.3390","volume":"27","author":[{"given":"Ludovica","family":"Pepe","sequence":"first","affiliation":[{"name":"Anatomic Pathology Unit, Department of Human Pathology in Adult and Developmental Age \u201cGaetano Barresi\u201d, University of Messina, 98125 Messina, Italy"},{"name":"PhD Program in Translational Molecular Medicine and Surgery, Department of Biomedical, Dental, Morphological and Functional Imaging Sciences, 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