三阴性乳腺癌组织中LAG-3、PD-1、PD-L1的表达和TIL计数的临床意义  

Expressions of LAG-3,PD-1,PD-L1 and TIL count in triple-negative breast cancer tissues and their clinical significance

作　　者：祝梦娇 罗昆仑[1,2] 芮小平 赵海滨 肖献秋 朱振成 朱庆洲 ZHU Mengjiao;LUO Kunlun;RUI Xiaoping;ZHAO Haibin;XIAO Xianqiu;ZHU Zhencheng;ZHU Qingzhou(Wuxi Clinical School of Anhui Medical University,Jiangsu Wuxi 214044,China;Department of General Surgery,the 904th Hospital of Joint Logistic Support Force of PLA,Jiangsu Wuxi 214044,China.;Departmentof Pathology,the 904th Hospital of Joint Logistic Support Force of PLA,Jiangsu Wuxi 214044,China)

机构地区：[1]安徽医科大学无锡临床医学院,江苏无锡214044 [2]中国人民解放军联勤保障部队第九〇四医院普通外科,江苏无锡214044 [3]中国人民解放军联勤保障部队第九〇四医院病理科,江苏无锡214044

出　　处：《现代肿瘤医学》2022年第11期1961-1966,共6页Journal of Modern Oncology

基　　金：南京军区医药卫生科研基金资助项目(编号:14D05)。

摘　　要：目的:探讨三阴性乳腺癌(triple-negative breast cancer,TNBC)组织中淋巴细胞激活基因-3(lymphocyte-activation gene-3,LAG-3)、程序性死亡受体-1(programmed death-1,PD-1)、程序性死亡受体-1配体(programmed death ligand-1,PD-L1)的表达和肿瘤浸润淋巴细胞(tumor infiltrating lymphocyte,TIL)计数的临床意义。方法:免疫组织化学法检测62例原发性TNBC组织和30例癌旁组织中LAG-3、PD-1、PD-L1的表达,苏木素-伊红法染色并计数TIL,分析四者与TNBC临床病理特征及预后的关系。结果:TNBC组织中LAG-3、PD-1和PD-L1表达显著高于癌旁组织(P<0.01);LAG-3表达与TNBC患者的淋巴结转移、Ki-67、PD-1、PD-L1表达和TIL计数有关(P<0.05);单因素分析显示,TNBC患者DFS与淋巴结转移、TNM分期、Ki-67、TIL、LAG-3^(+)PD-1^(+)、LAG-3^(+)PD-L1^(+)、LAG-3^(+)TIL^(low)有关(P<0.05);多因素分析显示,TNM分期、LAG-3^(+)PD-L1^(+)和TIL是TNBC患者预后的独立危险因素(P<0.05)。结论:TNM分期、LAG-3^(+)PD-L1^(+)和TIL与TNBC患者不良预后有关,特别是LAG-3和PD-L1结合共表达,可为免疫检查点双重阻滞在TNBC患者的临床应用中提供更多的理论依据。Objective:To investigate the expressions of LAG-3,PD-1,PD-L1 and TIL count in triple-negative breast cancer(TNBC)tissues and their clinical significance.Methods:Immunohistochemical method was used to detect the expression of LAG-3,PD-1 and PD-L1 in 62 cases of primary TNBC tissues and 30 cases of adjacent tissues.Hematoxylin-eosin method was used to evaluate TIL count,and analyze the relationship between the expression of the four and the clinicopathological characteristics and prognosis of TNBC.Results:The expressions of LAG-3,PD-1 and PD-L1 in TNBC tissue were significantly higher than those in adjacent tissues(P<0.01).LAG-3 expression is related to lymph node metastasis,Ki-67,PD-1,PD-L1 expressions,TIL count in TNBC patients(P<0.05).Univariate analysis showed that DFS in TNBC patients was related to lymph node metastasis,TNM stage,Ki-67,TIL,LAG-3^(+)PD-1^(+),LAG-3^(+)PD-L1^(+),LAG-3^(+)TIL^(low)(P<0.05).Multivariate analysis showed that TNM stage,LAG-3^(+)PD-L1^(+) and TIL were independent risk factors for the prognosis of TNBC patients(P<0.05).Conclusion:TNM stage,LAG-3^(+)PD-L1^(+) and TIL are related to the poor prognosis of TNBC patients.In particular,the combined co-expression of LAG-3 and PD-L1 can provide more theoretical basis for the clinical application of double immune checkpoint blockade in TNBC patients.

关 键 词：三阴性乳腺癌 淋巴细胞激活基因-3 程序性死亡受体-1 程序性死亡受体-1配体 肿瘤浸润淋巴细胞 预后 免疫治疗 

分 类 号：R737.9[医药卫生—肿瘤]