MSI、PD-L1在NSCLC患者中的表达及其与预后的相关性  

Expression of MSI and PD-L1 in NSCLC patients and their correlation with prognosis

作　　者：张文静[1] 章春芝[1] 王贵刚[1] 容宇[1] 韩媛媛[1] 陈丽君 ZHANG Wenjing;ZHANG Chunzhi;WANG Guigang;RONG Yu;HAN Yuanyuan;CHEN Lijun(Department of Thoracic and Cardiovascular Surgery,the First Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei,China,075000;Department of Emergency,the First Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei,China,075000)

机构地区：[1]河北北方学院附属第一医院胸心血管外科,河北张家口075000 [2]河北北方学院附属第一医院急诊科,河北张家口075000

出　　处：《分子诊断与治疗杂志》2021年第3期388-391,395,共5页Journal of Molecular Diagnostics and Therapy

基　　金：张家口市2020年市级科技计划(2021080D)。

摘　　要：目的探讨微卫星不稳定性(MSI)、程序性死亡配体-1(PD-L1)在非小细胞肺癌(NSCLC)患者中的表达水平及其预后相关性。方法收集2010年6月至2014年12月在本院收集的86例NSCLC患者手术切除癌组织及对应距病灶5 cm以上癌旁正常组织。利用PCR技术检测172例样品中BAT-25、BAT-26、D2S123、D5S346、D17S250五个位点的MSI,判断MSI表达情况。采用免疫组化法检测PD-L1的水平。对MSI、PD-L1与临床病理因素的关系进行分析,所有患者根据病情给予手术切除联合抗PD-L1等相应治疗,对影响NSCLC患者5年生存率的独立因素进行分析,观察MSI、PD-L1表达对患者5年生存率的影响。结果非小细胞癌组织中MSI表达率为63.95%,明显高于癌旁组织,差异有统计学意义(P<0.05)。PD-L1表达率明显高于癌旁正常组织,差异有统计学意义(P<0.05)。PD-L1表达与肿瘤分化程度、淋巴是否转移、TNM分期有关(P<0.05);MSI状态与肿瘤分化程度、淋巴结转移情况、TNM分期有关(P<0.05)。MSS及MSI-L患者术后生存时间明显低于MSI-H患者,差异有统计学意义(P<0.05)。PD-L1阳性患者术后生存时间明显低于阴性组,差异有统计学意义(P<0.05)。Logistic回归分析显示PD-L1阳性(OR=3.888)、淋巴结转移(OR=3.823)、TNM分期Ⅲ~Ⅳ期(OR=3.380)为影响患者5年生存率独立危险因素,MSI-H阳性为NSCLC患者5年生存率的保护因素(OR=0.289)(P<0.05)。结论 MSI和PD-L1的表达与NSCLC临床病理特征及预后密切相关,可作为NSCLC预后预测的重要指标。Objective To explore the expression levels of microsatellite instability(MSI)and programmed death ligand 1(PD-L1)in patients with non-small cell lung cancer(NSCLC)and their correlation with prognosis. Methods The surgically resected cancer tissues and normal para-cancerous tissues(over 5 cm away from corresponding lesions)from 86 NSCLC patients confirmed by the Department of Pathology,this Hospital from June 2010 to December 2014 were collected. MSI values at BAT-25,BAT-26,D2 S123,D5 S346 and D17 S250 loci from the 172 specimens was detected by PCR to determine the expression of MSI. The level of PDL1 was detected by immunohistochemistry. The relationship between MSI,PD-L1 and clinicopathological factors was analyzed. All patients were treated with surgical resection combined with anti-PD-L1 and other corresponding treatments according to the condition. The independent influencing factors of 5-year survival rate were analyzed. The effects of MSI and PD-L1 on 5-year survival rate were observed. Results The expression rates of MSI and PD-L1 in NSCLC tissues,significantly higher than those in para-cancerous normal tissues(P<0.05).The expression of PD-L1 is related to the degree of tumor differentiation,lymph node metastasis and TNM staging(P<0.05). MSI status is related to the degree of tumor differentiation,lymph node metastasis and TNM staging(P<0.05). The postoperative survival time in patients with MSS and MSI-L was significantly shorter than that with MSI-H(P<0.05). The postoperative survival time in patients with PD-L1 positive was significantly shorter than that with PD-L1 negative(P<0.05). Logistic regression analysis showed that PD-L1 positive(OR=3.888),lymph node metastasis(OR=3.823)and TNM stage Ⅲ-Ⅳ(OR=3.380)were independent risk factors that affect the 5-year survival rate,and MSI-H positive(OR=0.289)was a protective factor(P<0.05). Conclusion The expressions of MSI and PD-L1 are closely related to the clinicopathological characteristics and prognosis of NSCLC,and can be used as important indicators

关 键 词：MSI PD-L1 非小细胞肺癌 

分 类 号：R734.2[医药卫生—肿瘤]