不同表皮生长因子受体基因突变状态的肺腺癌中PD－1/PD－L1的表达  

Expression of PD-1/PD-L1 in lung adenocarcinoma and correlation with epidermal growth factor receptor mutation status

作　　者：王也[1,2] 笪冀平[2] 王秀红[2] 宋爱平[2] 陈皇[2] 张红雷[2] 陈圣 王德文[1] Wang Ye Da Jiping Wang Xiuhong Song Aiping Chen Huang Zhang Honglei Chen Sheng Wang Dewen(Institute of Radiation Medicine, Academy of Military Medical Sciences, Beijing 100850, China)

机构地区：[1]军事医学科学院放射与辐射医学研究所,北京100850 [2]中日友好医院病理科 [3]解放军火箭军总医院普通外科

出　　处：《中华病理学杂志》2016年第12期854-858,共5页Chinese Journal of Pathology

摘　　要：目的探讨肺腺癌中程序性死亡分子1（PD－1）及程序性死亡配体1（PD－L1）蛋白表达的情况及与临床病理参数之间的相关性，并分析不同表皮生长因子受体（EGFR）基因突变状态与PD－1、PD－L1表达的相关性。方法选取中日友好医院2010年8月至2016年1月间送检的109例浸润性肺腺癌手术标本，其中EGFR基因野生型51例，突变型58例。用免疫组织化学染色检测PD－1、PD－L1的蛋白表达。使用SAS 9.1软件分析实验结果，PD－1与PD－L1表达的相关性分析采用χ^2检验，PD－1、PD－L1的表达与临床病理参数的相关性分析采用χ^2检验。结果PD－1、PD－L1蛋白表达总体阳性率分别为68.8%（75/109）和27.5%（30/109），二者之间的相关性具有统计学意义（P〈0.05）。EGFR野生型的51例标本中，PD－1和PD－L1的阳性率（74.5%，39.2%）均高于EGFR突变型的58例标本（63.8%，17.2%），前一组PD－1和PD－L1表达之间的相关性具有统计学意义（P〈0.05），而后一组二者表达的相关性不具有统计学意义（P〉0.05）。PD－1的表达与年龄相关（P〈0.05）。PD－L1阳性表达与组织学分型、肿瘤大小、是否发生淋巴结转移及EGFR状态显著相关（P〈0.05）。结论不同EGFR状态下，PD－1与PD－L1蛋白表达特点不同。PD－L1过表达与较大的肿瘤直径及淋巴结转移密切相关，可以作为肺腺癌恶性程度较高的一个提示指标。Objective To investigate the expression of programmed cell death-1 （PD-1） and programmed cell death-ligand 1 （ PD-L1 ） in lung adenocarcinoma in correlation with clinical pathological parameters, especially with regard to different epidermal growth factor receptor （EGFR） mutation status. Methods One hundred and nine cases of lung adenocarcinoma were collected during the period from Aug. 2010 to Jan. 2016, including 51 cases of EGFR wild type and 58 cases of EGFR mutations. Immunohistocbemistry was used to detect PD-1/PD-L1 protein expression. Chi-square test was used to analyze the correlation between PD-1 and PD-L1 expression, and in correlation with clinicopathological parameters. All statistical analyses run by SAS 9, 1 software. Results The positive rates of PD-1 and PD- L1 expression were 68.8% （ 75/109 ） and 27.5% （ 30/109 ） , respectively, with significant correlation between the two （P 〈 O. 05）. PD-1 and PD-L1 expression rates were higher in 51 cases with EGFR wild type status （74. 5% and 39. 2% ） than those in 58 EGFR mutation cases （63.8% and 17.2% ） ; PD-1 expression was significantly associated with age （ P 〈 0. 05 ） ; that of PD-L1 was closely correlated with histological type, tumor size, lymph node metastasis and EGFR status （ P 〈 0. 05 ）. Conclusions PD-1 and PD-L1 expression profiles and their correlation with EGFR mutations are different from those with native EGFR. PD-L1 overexpression is closely correlated with larger tumor size and lymph node metastasis, suggesting it is a bi-h-a＇rade marker for lun- adenocarcinoma.

关 键 词：肺肿瘤 腺癌 受体 表皮生长因子 免疫组织化学 

分 类 号：R734.2[医药卫生—肿瘤]