肌层浸润性膀胱癌（MIBC）患者根治性膀胱切除术后复发的风险取决于肿瘤的病理分期。特别是，尽管接受新辅助化疗但仍有淋巴结转移（pN）、局部晚期（≥pT3）或残留肌肉浸润性肿瘤的患者处于高风险。目前，在围手术期全身治疗概念的背景下，免疫检查点抑制剂辅助治疗的重要性正在增加。目前欧盟批准的 PD-1 抑制剂纳武单抗的适应症需要通过免疫化学方法测试肿瘤组织中的 PD-L1（程序性细胞死亡配体 1）蛋白表达。关注复发风险高的 MIBC 患者，出现了有关 PD-L1 检测的实施和解释的新问题。来自德国的跨学科专家组从临床病理学的角度讨论了相关问题，并制定了实用建议，以促进在日常临床实践中针对已批准的适应症实施经过验证且有质量保证的 PD-L1 检测。© 2024。作者（ s）。

The risk of recurrence in patients with muscle invasive bladder cancer (MIBC) after radical cystectomy depends on the pathological tumor stage. In particular, patients with lymph node metastasis (pN+), locally advanced (≥pT3), or residual muscle invasive tumor despite neoadjuvant chemotherapy are at high risk. Currently, the importance of adjuvant therapy with immune checkpoint inhibitors is increasing in the context of perioperative systemic therapeutic concepts. The indication for the PD‑1 inhibitor nivolumab currently approved in the European Union requires testing of PD-L1 (programmed cell death ligand 1) protein expression by immunochemistry in tumor tissue. Focusing on MIBC patients at high risk of recurrence, new questions arise regarding the implementation and interpretation of PD-L1 testing. An interdisciplinary group of experts from Germany has discussed relevant issues from a clinicopathological point of view and developed practical recommendations to facilitate the implementation of validated and quality-assured PD-L1 testing for the approved indications in daily clinical practice.© 2024. The Author(s).