肺腺癌中PD-L1、B7H3的表达与EGFR基因突变的关系  

Relationship between PD-L1 and B7H3 expression and EGFR mutation in lung adenocarcinomas

作　　者：宋燕秋 吕坤聚[2] 王丽[2] 庞玲[2] 姜欣[3] 

机构地区：[1]青岛大学医学院,山东青岛266000 [2]中国人民解放军第401医院呼吸内科,山东青岛266000 [3]北京市新华通讯社门诊部,北京100803

出　　处：《临床肺科杂志》2016年第5期866-869,873,共5页Journal of Clinical Pulmonary Medicine

摘　　要：目的探讨程序性凋亡配体1(programmed death-ligand 1,PD-L1)、B7H3在肺腺癌中的表达与表皮生长因子受体(epidermal growth factor receptor,EGFR)基因突变状况的关系,为EGFR基因突变的肺腺癌患者提供一种新的临床治疗方法。方法收集78例手术切除的肺腺癌组织,所有标本均有EGFR基因检测结果。应用免疫组织化学PV-6 000法检测PD-L1、B7H3的表达情况。结果肺腺癌组织中有32例(41.0%)发生EGFR突变,其中女性的突变率高于男性(30.8%vs 10.3%,P<0.05),不吸烟者比吸烟者有更高的突变率(28.2%vs12.8%,P<0.05)。PD-L1、B7H3在EGFR突变型患者中的阳性率分别为71.9%、68.8%,均高于其在野生型患者中的发生率45.7%、43.5%(P<0.05),且均与21外显子突变密切相关(P<0.05),但未发现与19外显子突变相关(P>0.05)。PD-L1在女性、不吸烟者及II^III期中的表达水平高于男性、吸烟者及I期患者(P<0.05)。B7H3的表达与TNM分期及淋巴结转移情况相关(P<0.05)。PD-L1与B7H3表达呈正相关关系(P<0.05)。结论 PD-L1、B7H3高表达在EGFR突变型肺腺癌的发生发展中起重要作用,以PD-L1、B7H3为靶点的免疫治疗,可能成为这部分患者治疗的新方法。Objective To explore the relationship between the expression of programmed death ligand 1 （PD-L1） and B7H3 and epidermal growth factor receptor（EGFR） mutation status in lung adenocarcinoma, and to provide a new clinical treatment for lung adenocarcinorha patients harboring an activating EGFR mutation. Methods 78 specimens of surgically reseeted lung adenoearcinoma were enrolled, which had been examined for EGFR mutations. The expression of PD-L1 and B7H3 was determined with immunohistochemical staining method called PV-6 000. Results The EGFR mutations were found in 32 （41.0%） patients with lung adenocareinoma. Women and nonsmokers were found to be significantly associated with the incidence of EGFR gene mutations（ 30. 8% vs 10. 3%, P 〈0. 05; 28.2% vs 12. 8% , P 〈0.05）. The patients with EGFR mutations had higher active PD-L1 and active B7H3 staining （ P 〈 0. 05 ）. The expression of PD-L1 and B7H3 was closely related with EGFR exon 21 mutation （ P 〈 0. 05 ） , but had no relationship with EGFR exon 19 mutation （P 〉 O. 05 ）. A higher expression level of PD-L1 was observed in women, nonsmokers and patients at stage Ⅱ - Ⅲ （P 〈0. 05）. The expression of B7H3 was associated with TNM stage and lymph node status. There was a relationship between PD-L1 and B7H3 （P 〈 0.05）. Conclusion The high expression of PD-L1 and B7H3 plays an important role in the carcinogenesis and progress of lung adenocarcinoma harboring an activating EGFR mutation. The immunotherapy targeting to PD-L1 or B7H3 may become a novel approach to these patients.

关 键 词：PD-L1 B7H3 肺腺癌 免疫疗法 

分 类 号：R734.2[医药卫生—肿瘤]