PD-L1与PD-1在宫颈鳞癌与宫颈良性病变组织及外周血中的表达及其预后价值  

The expression level and prognostic value of PD-L1 and PD-1 in cervical squamous carcinoma and benign disease tissues and peripheral blood

作　　者：张宋安[1] 张洋[1] 古丽仙.吐鲁翁江 胡尔西旦.尼牙孜 张蕾[1] 迪丽达尔.斯地克 赵化荣[1] 

机构地区：[1]新疆医科大学第一附属医院,新疆乌鲁木齐830054

出　　处：《现代肿瘤医学》2018年第8期1246-1251,共6页Journal of Modern Oncology

基　　金：乌鲁木齐市科技计划项目(编号:Y141310033)

摘　　要：目的:通过分别对宫颈鳞癌、宫颈良性疾病组织和配对血液标本检测,了解外周血程序性死亡受体1(PD-1)与肿瘤组织程序性死亡受体-配体1(PD-L1)表达的一致性,初步评价其与宫颈鳞癌预后的关系。方法:收集宫颈鳞癌及宫颈良性病变组织标本各70例,并收集配对的外周血标本鳞癌24例,良性病变30例。免疫组化法检测组织PD-L1,流式细胞术检测外周血T细胞表面PD-1+亚群的比例,并结合生存资料做统计分析。结果:宫颈鳞癌患者外周血PD-1与组织PD-L1表达呈正相关(r^2=0.734,P=0.000;r^2=0.66,P=0.000),宫颈良性病变者外周与组织的表达不相关(r^2=0.138,P=0.043;r^2=0.174,P=0.022)。宫颈癌患者血CD8^+PD-1^+细胞百分比、组织PD-L1^+的细胞数大于宫颈良性病变组(P=0.000,P=0.002)。宫颈癌患者随肿瘤直径增大、分期升高,肿瘤组织PD-L1表达量也相应升高,外周T细胞表面PD-1表达也有类似趋势。但是外周T细胞表面PD-1表达程度与肿瘤大小、分化程度、深肌层侵犯均无关。单因素分析提示外周CD4^+T细胞低表达PD-1的、组织低表达PD-L1的患者生存期较长。多因素分析结果显示,PDL1表达对患者生存有影响(B=1.844,P=0.019)。结论:宫颈鳞癌患者外周血PD-1、组织PD-L1表达与肿瘤的分级、预后有关,组织PD-L1表达是患者的独立预后因素。Objective：By testing the expression of PD-1 in blood samples and PD-L1 in matched tissue samples between cervical squamous cancer and benign disease patients,combined with clinical data to investigate the correlation between the expression level and prognosis.Methods：70 cases of cervical squamous cell carcinoma and cervical benign lesion were collected,and in which 24 cancer cases and 30 benign disease cases were matched with peripheral blood.Immunohistochemistry method was used to detect the expression of PD-L1 in the tissues.Flow cytometry was used to detect the proportion of PD-1＋ subsets of T cells in peripheral blood.Survival data were also added to do statistical analysis.Results：The expression of PD-1 in peripheral blood was positively correlated with the expression of PD-L1 in tissue samples of cervical squamous cell carcinoma patients （r2=0.734,P=0.000,r2=0.66,P=0.000）,while there were less correlation in cervical benign patients （r2=0.138,P=0.043,r2=0.174,P=0.022）.The proportion of CD8＋PD-1＋subsets in peripheral T cells and number of PD-L1＋ cancer cells in tissue is higher in cancer patients than benign disease patients （P=0.000,0.002）.With the increase of tumor diameter and stage,the expression of PD-L1 in tumor tissue also increased.The PD-1＋ subsets of peripheral T cells seemed to share the same trend.But the proportion of PD-1＋ subsets of T cells didn＇t correlate with the tumor size,differentiation degree or deep myometrial invasion.Univariate analysis suggested that those cancer patients with low proportion of CD4＋PD-1＋ T cells and small number of PD-L1＋ cancer cells in tissue had long survival time.Multivariate analysis showed that the PFS time was affected by the expression of PD-L1（B=1.844,P=0.019）.Conclusion：The expression of PD-1 and PD-L1 of cervical squamous cell carcinoma patients correlated with the grade and prognosis of the tumor.The expression of PD-L1 was an independent prognostic factor.

关 键 词：宫颈癌 程序性死亡受体1 程序性死亡受体-配体1 预后 

分 类 号：R737.3[医药卫生—肿瘤]