肺腺癌程序性死亡配体1表达与表皮生长因子受体基因突变及T淋巴细胞功能状态的相关性  

Correlation of programmed cell death ligand 1 with epidermal growth factor receptor mutation and T lymphocyte function in lung adenocarcinoma

作　　者：李刚强[1] 方敏 朱瑞 周海亚 马雅雯 LI Gangqiang;FANG Min;ZHU Rui;ZHOU Haiya;MA Yawen(Department of Pathology , the 455M Hospital of PLA , Shanghai 200052 , China;Department of Quality Control, the 455M Hospital of PLA , Shanghai 200052 , China})

机构地区：[1]解放军第455医院病理科,上海200052 [2]解放军第455医院质控科,上海200052

出　　处：《中华实用诊断与治疗杂志》2019年第8期807-810,共4页Journal of Chinese Practical Diagnosis and Therapy

基　　金：南京军区医学科技创新课题(15ZD008)

摘　　要：目的探讨程序性死亡配体1(programmedcelldeathligand1,PD-L1)在肺腺癌中表达与表皮生长因子受体(epidermalgrowthfactorreceptor,EGFR)基因突变的关系及对T淋巴细胞的影响。方法85例肺腺癌患者为肺腺癌组,29例肺良性病变患者为对照组;采用免疫组织化学法检测2组手术切除组织中PD-L1和CD8阳性表达率,采用Sanger测序法检测肺腺癌组织中EGFR突变情况,分析肺腺癌组PD-L1阳性表达与临床病理特征的关系,采用Pearson相关分析肺腺癌组PD-L1阳性表达与EGFR突变、T淋巴细胞浸润的相关性。结果肺腺癌组组织中PD-L1阳性表达率(44.7%)高于对照组(0)(P<0.05);肺腺癌组不同性别、年龄及组织学类型患者PD-L1阳性表达率比较差异无统计学意义(P>0.05),肿瘤直径>2cm、临床分期Ⅱ~Ⅲ期、有淋巴结转移患者PD-L1阳性表达率(76.2%、55.2%、65.5%)高于肿瘤直径≤2cm(34.4%)、临床分期Ⅰ期(39.3%)及无淋巴结转移患者(33.9%)(P<0.05);EGFR突变型肺腺癌36例,EGFR野生型肺腺癌49例;EGFR突变型肺腺癌组织中PD-L1阳性表达率(58.3%)高于EGFR野生型(34.7%)(P<0.05);CD8阳性肺腺癌患者组织中PD-L1阳性表达率(25.0%)低于CD8阴性患者(56.6%)(P<0.05);PD-L1阳性表达与EGFR突变呈正相关(r=0.264,P=0.011),与T淋巴细胞浸润呈负相关(r=-0.575,P=0.010)。结论PD-L1可作为判断肺腺癌预后的新指标,PD-L1、EGFR及T淋巴细胞联合检测可为肺腺癌治疗提供新的分子依据。Objective To investigate the correlation of programmed cell death ligand 1(PD-L1) with the gene mutation of epidermal growth factor receptor(EGFR) and its effect on T lymphocyte in lung adenocarcinoma. Methods The positive rates of PD-L1 and CD8 were detected by immunohistochemistry in 85 patients with lung adenocarcinoma and 29 patients with benign lung diseases. Sanger sequencing method was used to detect EGFR mutation in lung adenocarcinoma tissue. The relationship between PD-L1 positive expression and clinicopathological characteristics was analyzed. Pearson correlation analysis was used to analyze the correlations of PD-L1 positive expression with EGFR mutation and T lymphocyte infiltration in lung adenocarcinoma tissue. Results The positive rate of PD-L1 was significantly higher in patients with lung adenocarcinoma(44.7%) than that in patients with benign lung diseases(0)(P<0.05), and showed no significant difference in different gender, age and histopathologic classification in patients with in lung adenocarcinoma(P>0.05). The positive rate of PD-L1 was significantly higher in patients with lung adenocarcinoma >2 cm in diameter, clinical stage Ⅱ-Ⅲ, and lymph node metastasis(76.2%, 55.2%, 65.5%) than that in patients with lung adenocarcinoma ≤2 cm in diameter, clinical stage Ⅰ and no lymph node metastasis(34.4%, 39.3%, 33.9%)(P<0.05). Sanger sequencing result showed EGFR mutant type in 36 patients and EGFR wild type in 49. The positive rate of PD-L1 was significantly higher in EGFR mutant type(58.3%) than that in EGFR wild type(34.7%), and was significantly lower in patients with CD8 positive(25.0%)than that in patients with CD8 neative(56.6%)(P<0.05).The positive expression of PD-L1 was positively correlated with EGFR mutation(r=0.264,P=0.011),and negatively correlated with T lymphocyte infiltration(r=-0.575,P=0.010).Conclusion PD-L1 can be used as a new indicator for predicting the prognosis of lung adenocarcinoma.The joint detection of PD-L1,EGFR and T lymphocytes may provide a new molecular basi

关 键 词：肺腺癌 程序性死亡配体1 表皮生长因子受体 T淋巴细胞 

分 类 号：R734.2[医药卫生—肿瘤]