非小细胞肺癌中PD-L1表达及其与肺癌相关驱动基因的关系  

Expression of PD-L1 and its correlation with driver oncogenes in non-small cell lung cancer

作　　者：林喜娜 李广秋[1] 何萍[1] 何新明[1] 林晓东[1] 顾霞[1] LIN Xi-na;LI Guang-qiu;HE Ping;HE Xin-ming;LIN Xiao-dong;GU Xia(Department of Pathology,the First Affiliated Hospital of Guangzhou Medical University,Guangzhou 510120,China)

机构地区：[1]广州医科大学附属第一医院病理科

出　　处：《临床与实验病理学杂志》2019年第7期767-771,共5页Chinese Journal of Clinical and Experimental Pathology

摘　　要：目的探讨程序性死亡配体-1(programmed death ligand-1,PD-L1)在非小细胞肺癌(non-small cell lung cancer,NSCLC)中的表达,及其与临床病理特征、肺癌相关驱动基因的关系。方法采用免疫组化EnVision法检测323例NSCLC肿瘤细胞、肿瘤浸润性免疫细胞PD-L1的表达;应用二代测序技术检测肺癌相关驱动基因(EGFR、KRAS、ALK)突变情况;分析PD-L1在肿瘤细胞、肿瘤浸润性免疫细胞中的表达,及与NSCLC临床病理特征及肺癌驱动基因的关系。结果NSCLC肿瘤浸润性免疫细胞PD-L1的表达明显高于肿瘤细胞(P<0.001);肿瘤细胞PD-L1在鳞状细胞癌(squamous cell carcinoma,SCC)中的表达高于腺癌(P<0.05)。当NSCLC肿瘤细胞中PD-L1阳性率≥50%时,PD-L1表达与患者性别、吸烟、肿瘤大小及淋巴结转移有关(P<0.05);腺癌中PD-L1表达仅与肿瘤大小及淋巴结转移相关(P<0.05)。肿瘤细胞PD-L1的表达与EGFR、KRAS基因突变相关(P<0.01)。NSCLC肿瘤浸润性免疫细胞PD-L1阳性率≥10%,PD-L1的表达与EGFR、KRAS基因突变有关(P<0.05),而腺癌PD-L1的表达仅与KRAS基因突变相关(P=0.036)。结论当肿瘤细胞PD-L1阳性率≥50%或肿瘤浸润性免疫细胞PD-L1阳性率≥10%,NSCLC、腺癌中PD-L1的表达与KRAS基因突变相关,提示伴KRAS基因突变的肺癌患者有可能从抗PD-1/PD-L1免疫治疗中获益,从而提高生存率。Purpose To explore the expression of programmed death ligand-1(PD-L1)and its relationship with clinicopathological parameters and driver oncogenes in non-small cell lung cancer.Methods Immunohistochemistry of EnVision was used to detect the expression of PD-L1 in tumor cells and immune cells in 323 cases of non-small cell lung cancers(NSCLC),and the mutation status of driver oncogenes(EGFR,KRAS,ALK)were determined by the second-generation sequencing technology.The relationship between the expression of tumor cells and immune cells PD-L1 and clinical parameters and driver oncogenes was analyzed.Results The expression of PD-L1 in immune cells was significantly higher than that of tumor cells in NSCLC(P<0.001),and the expression of PD-L1 in squamous cell carcinoma was higher than that in adenocarcinoma(P<0.05).When tumor cells PD-L1 was≥50%,the expression of PD-L1 was associated with gender,smoking,tumor size and lymph node metastasis in NSCLC(P<0.05),while it was only associated with tumor size and lymph node metastasis in adenocarcinoma(P<0.05).Moreover,the expression of PD-L1 in tumor cells was significantly associated with EGFR and KRAS mutation(P<0.01).Also,when PD-L1 expression was≥10%immune cells,it was associated with EGFR and KRAS mutation in NSCLC(P<0.05),but only associated with KRAS mutation in adenocarcinoma(P=0.036).Conclusion When the expression of PD-L1 in immune cells is≥50%or PD-L1 in tumor cells≥10%,it is associated with KRAS mutation in NSCLC and adenocarcinoma.It therefore suggests that lung cancer patients with KRAS mutation are more likely to benefit from anti-PD-1/PD-L1 immunotherapy and to improve overall survival rates.

关 键 词：肺肿瘤 非小细胞肺癌 腺癌 鳞状细胞癌 PD-L1 EGFR KRAS 

分 类 号：R734.2[医药卫生—肿瘤]