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Topic:Disease Diagnosis

Disease diagnosis in horses involves the identification and characterization of illnesses through various diagnostic methods and tools. This process is essential for effective veterinary care and management of equine health. Techniques used in diagnosing diseases in horses include clinical examinations, laboratory tests, imaging modalities such as ultrasonography and radiography, and molecular diagnostics. Blood tests are frequently utilized to assess parameters such as complete blood count and biochemical profiles, which can indicate underlying health issues. Additionally, advancements in genetic testing and biomarker identification have enhanced the ability to detect specific diseases early. This page aggregates peer-reviewed research studies and scholarly articles that explore diagnostic methodologies, their applications, and their impact on equine health management.
Electrical impedance tomography to measure lung ventilation distribution in healthy horses and horses with left-sided cardiac volume overload.
Journal of veterinary internal medicine    August 4, 2021   Volume 35, Issue 5 2511-2523 doi: 10.1111/jvim.16227
Sacks M, Byrne DP, Herteman N, Secombe C, Adler A, Hosgood G, Raisis AL, Mosing M.Left-sided cardiac volume overload (LCVO) can cause fluid accumulation in lung tissue changing the distribution of ventilation, which can be evaluated by electrical impedance tomography (EIT). Objective: To describe and compare EIT variables in horses with naturally occurring compensated and decompensated LCVO and compare them to a healthy cohort. Methods: Fourteen adult horses, including university teaching horses and clinical cases (healthy: 8; LCVO: 4 compensated, 2 decompensated). Methods: In this prospective cohort study, EIT was used in standing, unsedated horses and analyzed for convent...
Development and Validation of a Test for the Classification of Horses as Broken or Unbroken.
Animals : an open access journal from MDPI    August 4, 2021   Volume 11, Issue 8 2303 doi: 10.3390/ani11082303
Menchetti L, Dalla Costa E, Minero M, Padalino B.Regulation EC 1/2005 has stricter rules for transportation of unbroken (untamed) vs. broken (tamed) horses, but does not provide adequate tools for their identification. This study aimed to develop and validate such a tool. A behavioural test (Broken/Unbroken Test (BUT)) based on approaching, haltering, and leading was applied to 100 horses. Physiological and additional behavioural data were also collected, and the horses' status (broken/unbroken) was assessed by the expert who administered the BUT. Each horse's behaviour during the BUT was scored by four trained observers blinded to the horse...
Cryotherapy provides transient analgesia in an induced lameness model in horses.
The Canadian veterinary journal = La revue veterinaire canadienne    August 4, 2021   Volume 62, Issue 8 834-838 
Quam V, Yardley J, Quam M, Paz C, Belknap J.The analgesic effect of cryotherapy in an induced lameness model was evaluated. Lameness was induced with solar pressure from a custom-made shoe in a 10-horse, cross-over study. The degree of lameness was recorded with a commercial non-invasive inertial sensor. The distal limbs were maintained in an ice and water slurry (cryotherapy) or at ambient temperature (control) for 1 hour. Lameness was assessed serially over the following hour. Lameness at each time point was compared to the baseline induced lameness, within and between groups. Lameness had improved significantly in all horses 5 minute...
Some Genetic and Environmental Effects on Equine Asthma in Polish Konik Horses.
Animals : an open access journal from MDPI    August 3, 2021   Volume 11, Issue 8 2285 doi: 10.3390/ani11082285
Borowska A, Wolska D, Niedzwiedz A, Borowicz H, Jaworski Z, Siemieniuch M, Szwaczkowski T.Current knowledge of the genetic and environmental backgrounds of equine asthma seems to be insufficient, especially for primitive horse breeds. The main objectives of this study were to estimate the effects of sex, birth period, stud, parentage line and inbreeding on asthma morbidity in Polish Konik horses. Records of 274 horses (housed in two studs) were analysed. These animals were allocated to maternal and paternal lines. Individual inbreeding coefficients were extracted from the additive relationship matrix. Horses underwent diagnosis based on observation of the basic symptoms (high frequ...
Evaluation of a new portable 1-lead digital cardiac monitor (eKuore) compared with standard base-apex electrocardiography in healthy horses.
PloS one    August 3, 2021   Volume 16, Issue 8 e0255247 doi: 10.1371/journal.pone.0255247
Vitale V, Vezzosi T, Tognetti R, Fraschetti C, Sgorbini M.Recently, the use of smartphone ECG devices has been reported in humans and animals. Nevertheless, as the electrodes of these devices are inseparable, they can create only a precordial reading in veterinary species. Thus, although the smartphone ECG devices are considered valuable as a screening tool for the detection of some common arrhythmias, they are not always a reliable method for the measurement of the duration of the electrical deflections. The objectives of this study were to evaluate the feasibility of a novel smartphone ECG device, to report the readings obtained recorded simultaneo...
Equine infection with Leishmania spp. in Costa Rica: Study of five cases.
Veterinary medicine and science    August 2, 2021   Volume 7, Issue 6 2234-2239 doi: 10.1002/vms3.587
Ortega-García MV, Salguero FJ, García N, Domínguez M, Moreno I, Berrocal A.Cutaneous forms of leishmaniosis due to Leishmania braziliensis have been reported in horses in the New World. Domestic animals play a role in the transmission of the disease. In Costa Rica, human cases of L. braziliensis, L. panamensis and L. infantum have been reported. The present report describes five cases of equine cutaneous leishmaniosis in Costa Rica. The aetiological diagnosis was based on the presence of the parasite within the lesions. Skin biopsies were used to perform histopathological analyses of the lesions. Immunohistochemistry was used to detect the presence of the Leishmania ...
Simulated validation of intron-less transgene detection using DELLY for gene-doping control in horse sports.
Animal genetics    August 2, 2021   Volume 52, Issue 5 759-761 doi: 10.1111/age.13127
Tozaki T, Ohnuma A, Kikuchi M, Ishige T, Kakoi H, Hirota K, Kusano K, Nagata S.Gene doping is prohibited in horseracing. In a previous study, we developed a method for non-targeted transgene detection using DELLY, which is based on split-read (SR) and paired-end (PE) algorithms to detect structural variants, on WGS data. In this study, we validated the detection sensitivity of DELLY using artificially generated sequence data of 12 target genes. With DELLY, at least one intron was detected as a deletion in eight targeted genes using the 150 bp PE read WGS data, whereas all targeted genes were detected by DELLY using the 100 bp PE read data. The detection sensitivity was h...
Increased α-tocopherol metabolism in horses with equine neuroaxonal dystrophy.
Journal of veterinary internal medicine    July 31, 2021   Volume 35, Issue 5 2473-2485 doi: 10.1111/jvim.16233
Hales EN, Habib H, Favro G, Katzman S, Sakai RR, Marquardt S, Bordbari MH, Ming-Whitfield B, Peterson J, Dahlgren AR, Rivas V, Ramirez CA, Peng S....Equine neuroaxonal dystrophy/equine degenerative myeloencephalopathy (eNAD/EDM) is an inherited neurodegenerative disorder associated with a vitamin E deficiency within the first year of life. Vitamin E consists of 8 isoforms metabolized by the CYP4F2 enzyme. No antemortem diagnostic test currently exists for eNAD/EDM. Objective: Based on the association of α-tocopherol deficiency with the development of eNAD/EDM, we hypothesized that the rate of α-tocopherol, but not γ-tocopherol or tocotrienol metabolism, would be increased in eNAD/EDM-affected horses. Methods: Vitamin E metabolism: Proof...
The Structural Biology of Eastern Equine Encephalitis Virus, an Emerging Viral Threat.
Pathogens (Basel, Switzerland)    July 31, 2021   Volume 10, Issue 8 973 doi: 10.3390/pathogens10080973
Hasan SS, Dey D, Singh S, Martin M.Alphaviruses are arboviruses that cause arthritis and encephalitis in humans. Eastern Equine Encephalitis Virus (EEEV) is a mosquito-transmitted alphavirus that is implicated in severe encephalitis in humans with high mortality. However, limited insights are available into the fundamental biology of EEEV and residue-level details of its interactions with host proteins. In recent years, outbreaks of EEEV have been reported mainly in the United States, raising concerns about public safety. This review article summarizes recent advances in the structural biology of EEEV based mainly on single-par...
Comparative evaluation of clinical findings and prognostic outcome parameters in hospitalized, critically ill neonatal foals and crias.
Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001)    July 29, 2021   Volume 31, Issue 5 619-628 doi: 10.1111/vec.13093
Bedenice D, Avila B, Paradis MR.Species-related differences in the prevalence, manifestation, and outcome of neonatal illness may impact management practices of neonatal intensive care. The study aimed to elucidate similarities between disease manifestations and mortality risks of critically ill (CI) neonatal crias and foals admitted to the same referral center. Methods: A comparative, retrospective cohort evaluation of two species (camelid and equine). Methods: The study was conducted in a University hospital. Methods: Two hundred and forty-six CI neonatal crias (January 1999 to May 2016) and 356 neonatal foals (February 20...
Molecular analysis of G3P[6] rotavirus in the Amazon region of Brazil: evidence of reassortment with equine-like strains.
Future microbiology    July 28, 2021   Volume 16 847-862 doi: 10.2217/fmb-2020-0002
Silva Serra AC, Júnior EC, Cruz JF, Lobo PS, Júnior ET, Bandeira RS, Bezerra DA, Mascarenhas JD, Santos Guerra SF, Soares LS. To perform a molecular analysis of rotavirus A (RVA) G3P[6] strains detected in 2012 and 2017 in the Amazon region of Brazil. Eighteen RVA G3P[6] strains were collected from children aged under 10 years hospitalized with acute gastroenteritis, and partial sequencing of each segment genome was performed using Sanger sequencing. Phylogenetic analysis showed that all G3P[6] strains had a DS-1-like genotype constellation. Two strains had the highest nucleotide identities with equine-like G3P[6]/G3P[8] genotypes. Several amino acid alterations in VP4 and VP7 neutralizing epitopes of equine-l...
Gentamicin-induced sensorineural auditory loss in healthy adult horses.
Journal of veterinary internal medicine    July 28, 2021   Volume 35, Issue 5 2486-2494 doi: 10.1111/jvim.16221
Aleman MR, True A, Scalco R, Crowe CM, Costa LRR, Chigerwe M.Irreversible sensorineural auditory loss has been reported in humans treated with aminoglycosides but not in horses. Objective: Investigate if auditory loss occurs in horses treated using the recommended IV daily dosage of gentamicin for 7 consecutive days. Methods: Ten healthy adult horses (7-15 years; females and males, 5 each). Methods: Prospective study. Physical and neurological examinations and renal function tests were performed. Gentamicin sulfate was administered at a dosage of 6.6 mg/kg via the jugular vein on alternating sides for 7 days. Gentamicin peak and trough concentratio...
Clinical Presentation and Laboratory Diagnostic Work-Up of a Horse with Tick-Borne Encephalitis in Switzerland.
Viruses    July 28, 2021   Volume 13, Issue 8 1474 doi: 10.3390/v13081474
Fouché N, Oesch S, Ziegler U, Gerber V.Tick-borne encephalitis is an important viral tick-borne zoonosis in Europe and Asia. The disease is induced by tick-borne encephalitis virus (TBEV). This report describes a 16-year-old Warmblood gelding presenting with sudden onset of lethargy, ataxia, and muscle fasciculations on the nostrils, the lips, and the eye lids as the most important clinical findings. The horse further had a mild facial nerve paralysis with drooping of the right upper and lower lip. Diagnosis was based on paired serum samples using TBEV-ELISAs revealing high serum IgM in the first sample with normal IgM in the secon...
The first case of Tyzzer’s disease in a young foal in Italy: a case report.
Veterinaria italiana    July 27, 2021   Volume 57, Issue 3 doi: 10.12834/VetIt.1983.12227.1
Ellero N, Lanci A, Avallone G, Mariella J, Castagnetti C, Muscatello LV, Di Maio C, Freccero F.Seizures, coma and death rapidly appeared after admission in a one ‑month‑old foal with a history of lethargy, fever and anorexia. Severe icterus and necrotizing hepatitis were observed at necropsy. Clinical signs, laboratory and postmortem findings were compatible with a suspect of clostridial hepatitis. Tyzzer’s disease was confirmed by the presence of organisms morphologically consistent with Clostridium piliforme in the hepatocytes at the margins of multiple areas of hepatic necrosis. To the authors’ knowledge, this is the first reported case of clostridial hepatitis caused by Clos...
A comprehensive review on avian chlamydiosis: a neglected zoonotic disease.
Tropical animal health and production    July 27, 2021   Volume 53, Issue 4 414 doi: 10.1007/s11250-021-02859-0
Ravichandran K, Anbazhagan S, Karthik K, Angappan M, Dhayananth B.Avian chlamydiosis is one of the important neglected diseases with critical zoonotic potential. Chlamydia psittaci, the causative agent, affects most categories of birds, livestock, companion animals, and humans. It has many obscured characters and epidemiological dimensions, which makes it unique among other bacterial agents. Recent reports on transmission from equine to humans alarmed the public health authorities, and it necessitates the importance of routine screening of this infectious disease. High prevalence of spill-over infection in equines was associated with reproductive losses. New...
Constitutive and differential expression of transport protein genes in Parascaris univalens larvae and adult tissues after in vitro exposure to anthelmintic drugs.
Veterinary parasitology    July 24, 2021   Volume 298 109535 doi: 10.1016/j.vetpar.2021.109535
Martin F, Eydal M, Höglund J, Tydén E.The equine roundworm Parascaris univalens has developed resistance to the three anthelmintic substances most commonly used in horses. The mechanisms responsible for resistance are believed to be multi-genic, and transport proteins such as the P-glycoprotein (Pgp) family have been suggested to be involved in resistance in several parasites including P. univlaens. To facilitate further research into the mechanisms behind drug metabolism and resistance development in P. univalens we aimed to develop an in vitro model based on larvae. We developed a fast and easy protocol for hatching P. univalens...
Small intestinal pseudodiverticulosis in a pony mare. Leventhal HR, Hassebroek AM, Carvallo F, McKenzie HC.A 14-y-old pony mare was referred after 30-d duration of intermittent pyrexia, anorexia, weight loss, and change in manure consistency. Physical examination revealed a palpable but reducible ventral abdominal mass. Transabdominal ultrasonography revealed multiple distended, hypomotile, and thickened small intestinal loops in close approximation with numerous, well-defined, hyperechoic masses. There was a large amount of echogenic peritoneal fluid; abdominocentesis revealed a neutrophilic and macrophagic inflammatory exudate, and a mixed bacterial population was cultured. Given the poor prognos...
Identical Viral Genetic Sequence Found in Black Flies (Simulium bivittatum) and the Equine Index Case of the 2006 U.S. Vesicular Stomatitis Outbreak.
Pathogens (Basel, Switzerland)    July 23, 2021   Volume 10, Issue 8 doi: 10.3390/pathogens10080929
Drolet BS, Reeves WK, Bennett KE, Pauszek SJ, Bertram MR, Rodriguez LL.In 2006, vesicular stomatitis New Jersey virus (VSNJV) caused outbreaks in Wyoming (WY) horses and cattle after overwintering in 2004 and 2005. Within two weeks of the outbreak onset, 12,203 biting flies and 194 grasshoppers were collected near three equine-positive premises in Natrona County, WY. Insects were identified to the species level and tested by RT-qPCR for VSNJV polymerase (L) and phosphoprotein (P) gene RNA. Collected dipterans known to be competent for VSV transmission included Simulium black flies and Culicoides biting midges. VSNJV L and P RNA was detected in two pools of female...
Andrological and cytogenetic investigations of an infertile Przewalski’s stallion.
Acta veterinaria Hungarica    July 22, 2021   Volume 69, Issue 2 189-193 doi: 10.1556/004.2021.00027
Kútvölgyi G, Brabender K, Andersson M, Javkhlan A, Nagy S, Páble T, Egerszegi I, Hidas A, Soós I, Kovács A.The case of an 8-year-old, sexually active but infertile Przewalski's stallion (Equus ferus przewalskii) was studied. Besides the infertility, the stallion also showed permanent problems with its body condition, being obviously weaker than all the other group members. The horse was kept in a separate place for two years with 12 mares in its harem group (six mares had foals earlier); however, none of the mares covered got pregnant. Andrological and cytogenetic investigations revealed underdeveloped testes, arrested spermatogenesis, azoospermia, and XY/XXY/X0 mosaicism. We classify the case as a...
African Horse Sickness Virus Serotype 1 on Horse Farm, Thailand, 2020.
Emerging infectious diseases    July 22, 2021   Volume 27, Issue 8 2208-2211 doi: 10.3201/eid2708.210004
Bunpapong N, Charoenkul K, Nasamran C, Chamsai E, Udom K, Boonyapisitsopa S, Tantilertcharoen R, Kesdangsakonwut S, Techakriengkrai N, Suradhat S....To investigate an outbreak of African horse sickness (AHS) on a horse farm in northeastern Thailand, we used whole-genome sequencing to detect and characterize the virus. The viruses belonged to serotype 1 and contained unique amino acids (95V,166S, 660I in virus capsid protein 2), suggesting a single virus introduction to Thailand.
Increased fibroblast accumulation in the equine heart following persistent atrial fibrillation.
International journal of cardiology. Heart & vasculature    July 20, 2021   Volume 35 100842 doi: 10.1016/j.ijcha.2021.100842
Saljic A, Friederike Fenner M, Winters J, Flethøj M, Eggert Eggertsen C, Carstensen H, Dalgas Nissen S, Melis Hesselkilde E, van Hunnik A....Fibroblasts maintain the extracellular matrix homeostasis and may couple to cardiomyocytes through gap junctions and thereby increase the susceptibility to slow conduction and cardiac arrhythmias, such as atrial fibrillation (AF). In this study, we used an equine model of persistent AF to characterize structural changes and the role of fibroblasts in the development of an arrhythmogenic substrate for AF. Methods: Eleven horses were subjected to atrial tachypacing until self-sustained AF developed and were kept in AF for six weeks. Horses in sinus rhythm (SR) served as control. In terminal open...
Isothermal Nucleic Acid Amplification Technologies for the Detection of Equine Viral Pathogens.
Animals : an open access journal from MDPI    July 20, 2021   Volume 11, Issue 7 2150 doi: 10.3390/ani11072150
Knox A, Beddoe T.The global equine industry provides significant economic contributions worldwide, producing approximately USD $300 billion annually. However, with the continuous national and international movement and importation of horses, there is an ongoing threat of a viral outbreak causing large epidemics and subsequent significant economic losses. Additionally, horses serve as a host for several zoonotic diseases that could cause significant human health problems. The ability to rapidly diagnose equine viral diseases early could lead to better management, treatment, and biosecurity strategies. Current s...
In Vitro Assays for the Assessment of Impaired Mitochondrial Bioenergetics in Equine Atypical Myopathy.
Life (Basel, Switzerland)    July 20, 2021   Volume 11, Issue 7 doi: 10.3390/life11070719
Kruse CJ, Stern D, Mouithys-Mickalad A, Niesten A, Art T, Lemieux H, Votion DM.Equine atypical myopathy is a seasonal intoxication of grazing equids. In Europe, this poisoning is associated with the ingestion of toxins contained in the seeds and seedlings of the sycamore maple (Acer pseudoplatanus). The toxins involved in atypical myopathy are known to inhibit ß-oxidation of fatty acids and induce a general decrease in mitochondrial respiration, as determined by high-resolution respirometry applied to muscle samples taken from cases of atypical myopathy. The severe impairment of mitochondrial bioenergetics induced by the toxins may explain the high rate of mortality obs...
Equine parvovirus-hepatitis is detected in South America, Brazil.
Transboundary and emerging diseases    July 20, 2021   Volume 69, Issue 5 3022-3027 doi: 10.1111/tbed.14226
de Moraes MVDS, Salgado CRS, Godoi TLOS, de Almeida FQ, Chalhoub FLL, de Filippis AMB, de Souza AM, de Oliveira JM, Figueiredo AS.The equine parvovirus-hepatitis (EqPV-H), recently identified in association with serum hepatitis in horses (also known as Theiler's disease), has been so far described in horses from North America, Asia and Europe. There is no information regarding its circulation in South America. Our retrospective study (2013-2016) screened by EqPV-H nested-PCR a total of 96 Brazilian horses grouped according to previous status of infection: Known to be positive for one or more horse "hepatitis viruses" (equine hepacivirus, equine pegivirus-EPgV and Theiler's disease-associated virus) and known to be negati...
Establishment of a Three-Dimensional In Vitro Model of Equine Papillomavirus Type 2 Infection.
Viruses    July 19, 2021   Volume 13, Issue 7 1404 doi: 10.3390/v13071404
Ramsauer AS, Wachoski-Dark GL, Fraefel C, Ackermann M, Brandt S, Grest P, Knight CG, Favrot C, Tobler K.There is growing evidence that equine papillomavirus type 2 (EcPV2) infection is etiologically associated with the development of genital squamous cell carcinoma (SCC) and precursor lesions in equids. However, the precise mechanisms underlying neoplastic progression remain unknown. To allow the study of EcPV2-induced carcinogenesis, we aimed to establish a primary equine cell culture model of EcPV2 infection. Three-dimensional (3D) raft cultures were generated from equine penile perilesional skin, plaques and SCCs. Using histological, molecular biological and immunohistochemical methods, rafts...
On the possible role of food allergy in chronic urticaria in racing horses.
Veterinary dermatology    July 19, 2021   Volume 33, Issue 1 103-104 doi: 10.1111/vde.12964
Favrot C, Olivry T.No abstract available
Screening for gene doping transgenes in horses via the use of massively parallel sequencing.
Gene therapy    July 19, 2021   Volume 29, Issue 5 236-246 doi: 10.1038/s41434-021-00279-1
Maniego J, Pesko B, Habershon-Butcher J, Huggett J, Taylor P, Scarth J, Ryder E.Throughout the history of horse racing, doping techniques to suppress or enhance performance have expanded to match the technology available. The next frontier in doping, both in the equine and human sports areas, is predicted to be genetic manipulation; either by prohibited use of genome editing, or gene therapy via transgenes. By using massively-parallel sequencing via a two-step PCR method we can screen for multiple doping targets at once in pooled primer sets. This method has the advantages of high scalability through combinational indexing, and the use of reference standards with altered ...
Invasive leiomyosarcoma involving the tongue of an Arabian mare.
Journal of equine veterinary science    July 18, 2021   Volume 104 103718 doi: 10.1016/j.jevs.2021.103718
Pinzón-Osorio CA, Meneses-Martínez H, Botero-Espinosa L, Herrera-Luna CV.A 10 year-old endurance Arabian mare was presented with an invasive, firm, multilobulated mass at the left ventral face of the tongue. The mare had a history of four months of ptyalism, dysphagia, severe halitosis, and dysmastication. The Evaluation of the horse included physical and oral examination, complete blood count and serum biochemistry profile, computed tomography evaluation of the head, and histopathology of the mass. The computerized tomography (CT) head scan showed the homogeneous mass in the oral cavity confirming the degree of invasion on the tongue, as well as a small mineral fo...
Development and Application of a Multiplex Real-Time Polymerase Chain Reaction Assay for the Simultaneous Detection of Bacterial Aetiologic Agents Associated With Equine Venereal Diseases.
Journal of equine veterinary science    July 17, 2021   Volume 105 103721 doi: 10.1016/j.jevs.2021.103721
Kim SH, Lee JS, Lee JH, Kim YJ, Choi JG, Lee SK, Kim HJ, Yang SJ, Park T, Lee SK, Kang HE, Jeoung HY, Park JY.Venereal diseases caused by bacteria are important to the equine industry due to economic losses caused by decline of conception rate in breeding horses. Therefore, identification of infected animals as well as the implementation of appropriate managerial procedures based on accurate diagnosis is critical. In this study, two types of multiplex real-time polymerase chain reaction with high sensitivity and specificity were developed for the simultaneous detection and differentiation of five commonly associated bacterial pathogens of venereal diseases in horses, consisting of Taylorella equigenit...
PD-L1/PD-1 and CTLA-4 Expression in Equine Penile Squamous Cell Carcinomas.
Animals : an open access journal from MDPI    July 16, 2021   Volume 11, Issue 7 2121 doi: 10.3390/ani11072121
Porcellato I, Mecocci S, Brachelente C, Cappelli K, Armando F, Tognoloni A, Chiaradia E, Stefanetti V, Mechelli L, Pepe M, Gialletti R, Passeri B....In horses, penile squamous cell carcinomas (epSCCs) are among the most common cutaneous neoplastic lesions. These tumors usually arise in benign lesions such as viral plaques and papillomas frequently induced by papillomavirus type 2 (EcPV2) infection. In the last decade, the introduction of immune checkpoint inhibitors (ICI) for the treatment of human cancers has demonstrated promising results. Among the most commonly targeted pathways, there is PD-1/PD-L1 and CTLA-4. The aim of this study is to investigate the expression of the PD-1/PD-L1 pathway and CTLA-4 in the tumor microenvironment of ...
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