Spindle-shaped cells as well as hobnail patterns and carcinoma in situ were observed in the CDC tissue (Fig. 4), and immunohistochemistry using an anti-PD-L1 (clone 28-8) antibody demonstrated that PD-L1 was highly expressed with a tumor proportion score of more than 10% (Fig. 5). The gene discussed is CD274; the disease is in situ carcinoma.