头颈部原发性黏膜恶性黑色素瘤患者PD-L1表达及其临床相关因素分析  

Clinical relevance of PD-L1 expression in primary mucosal malignant melanoma of the head and neck

作　　者：王静[1] 李振东[1] 

机构地区：[1]辽宁省肿瘤医院头颈外科,辽宁沈阳110042

出　　处：《现代肿瘤医学》2017年第4期547-550,共4页Journal of Modern Oncology

摘　　要：目的:探讨头颈部原发性黏膜恶性黑色素瘤患者程序性细胞死亡配体1(PD-L1)表达及其临床意义。方法:研究采用免疫组化检测45例头颈部原发性黏膜恶性黑色素瘤样本PD-L1表达,分析其表达与患者临床病理学特征及疾病预后的关系。结果:所有患者均接受手术切除治疗联合干扰素治疗。随访患者5年生存率为44.4%(20/45),平均生存期为51个月,无复发生存期为23个月。免疫组化染色证实57.8%(26/45)肿瘤样本为PD-L 1高表达,显著多与临近非肿瘤组织(P=0.003 7)。PD-L1表达与患者年龄(P=0.09)、性别(P=0.16)、肿瘤分布(P=0.08)无关,而PD-L1阳性患者的无复发生存期显著短于阴性患者(P=0.027)。多变量分析证实PD-L1高表达是头颈部原发性黏膜恶性黑色素瘤患者预后不良独立标志物。结论:PD-L1高表达与头颈部原发性黏膜恶性黑色素瘤进展和预后不良密切相关,可以作为该疾病的预后标志物。Objective： To identify the PD- L1 expression pattern in primary mucosal malignant melanoma,to investigate clinicopathological and outcome associations. Methods： We assessed PD- L1 expression using immunohistochemical staining in 45 tumor samples from patients with primary mucosal melanoma and correlated expression status with clinicopathological and outcome data. Results： All patients had undergone surgery combined with interferon therapy. The probability of 5-year overall survival was 44.4 %. The mean overall survival was 51 months and the mean recurrence- free survival was 23 months. Immunohistochemical staining showed PD- L1 expression was in 57. 8 %（ 26 /45） of mucosal melanoma. In contrast,prominent PD-L1 staining was detected in 6.7 %（ 3 /45） of tissue sections from a control group of cutaneous melanoma（P = 0. 003 7）. PD-L1 expression in mucosal melanoma was not correlated with age（ P = 0. 09）,gender（P = 0. 16）,localization of the tumor（P = 0. 08）. Interestingly,patients with PD- L1- positive mucosal melanoma had a significantly longer recurrence- free survival（P = 0. 027）. Conclusion：High expression of PD- L1 is associated with poor prognosis as well as clinical progression in primary mucosal malignant melanoma.

关 键 词：头颈部肿瘤 黏膜黑色素瘤 免疫组化 PD-L1 

分 类 号：R739.91[医药卫生—肿瘤]