口腔鳞状细胞癌原发灶与淋巴结转移灶程序性死亡配体1表达对比分析  

Comparison of programmed death-ligand 1 protein expression between primary tumors and lymphnodemetastaticlesionsinoral squamouscellcarcinoma

作　　者：夏荣辉[1] 胡宇华[1] 张春叶[1] 徐声铭 李江[1] Xia Ronghui;Hu Yuhua;Zhang Chunye;Xu Shengming;Li Jiang(Department of Oral Pathology,Shanghai Ninth People′s Hospital,Shanghai Jiao Tong University School of Medicine&College of Stomatology,Shanghai Jiao Tong University&National Center for Stomatology&National Clinical Research Center for Oral Diseases&Shanghai Key Laboratory of Stomatology&Shanghai Research Institute of Stomatology,Shanghai 200011,China;Department of Oral and Maxillofacial-Head Neck Oncology,Shanghai Ninth People′s Hospital,Shanghai Jiao Tong University School of Medicine&College of Stomatology,Shanghai Jiao Tong University&National Center for Stomatology&National Clinical Research Center for Oral Diseases&Shanghai Key Laboratory of Stomatology&Shanghai Research Institute of Stomatology,Shanghai 200011,China)

机构地区：[1]上海交通大学医学院附属第九人民医院口腔病理科上海交通大学口腔医学院国家口腔医学中心国家口腔疾病临床医学研究中心上海市口腔医学重点实验室上海市口腔医学研究所,上海200011 [2]上海交通大学医学院附属第九人民医院口腔颌面头颈肿瘤科上海交通大学口腔医学院国家口腔医学中心国家口腔疾病临床医学研究中心上海市口腔医学重点实验室上海市口腔医学研究所,上海200011

出　　处：《中华口腔医学杂志》2022年第11期1113-1118,共6页Chinese Journal of Stomatology

基　　金：国家自然科学基金(82141108,81702694);上海交通大学医学院附属第九人民医院“精才培育项目”(JC201901)。

摘　　要：目的探讨口腔鳞状细胞癌(oral squamous cell carcinoma,OSCC)原发灶与淋巴结转移灶程序性死亡配体1(programmed death-ligand 1,PD-L1)表达差异。方法筛选2020年12月至2021年7月于上海交通大学医学院附属第九人民医院口腔病理科诊断为OSCC,并同期进行颈淋巴结清扫术且有淋巴结转移灶的82例病例,其中女性28例,男性54例。年龄(58.6±11.7)岁(24-79岁)。采用免疫组化方法检测患者原发灶和淋巴结转移灶中PD-L1蛋白表达,并进行联合阳性评分(combined positive score,CPS),分析原发灶和转移灶PD-L1表达差异。结果82例OSCC的原发灶中,9例(11%)CPS<1分,31例(38%)CPS≥1且<20分,42例(51%)CPS≥20分,CPS低的病例具有更高的神经侵犯比例(χ^(2)=6.35,P=0.042)。配对的82例淋巴结转移灶中,9例(11%)CPS<1分,38例(46%)CPS≥1且<20分,35例(43%)CPS≥20分。27对(33%)原发灶和转移灶CPS不一致,一致性评估结果显示,OSCC原发灶和转移灶中PD-L1 CPS一致性一般(Kappa值为0.446)。结论OSCC原发灶与颈部淋巴结转移灶PD-L1表达存在差异,一致性一般,在临床工作中应谨慎采用淋巴结转移灶替代原发灶进行PD-L1 CPS评判。Objective To investigate the difference of programmed death-ligand 1(PD-L1)expression between primary lesions and lymph node metastatic lesions in oral squamous cell carcinoma.Methods Eighty-two patients diagnosed with oral squamous cell carcinoma from December 2020 to July 2021 in Department of Oral Pathology,Shanghai Ninth People′s Hospital,Shanghai Jiao Tong University School of Medicine&College of Stomatology,Shanghai Jiao Tong University,were enrolled in this study.All the patients underwent neck dissection concurrently and had lymph node metastasis.Among them,there were 28 females and 54 males.The age range was 24-79 years old[(58.6±11.7)years old].The expression of PD-L1 protein in primary tumors and lymph node metastatic lesions was detected by immunohistochemistry.Combined positive score(CPS)was used to evaluate the PD-L1 expression.And the difference of PD-L1 expression between primary tumors and metastatic lesions was analyzed.Results Among 82 primary tumors,9 cases(11%)had PD-L1 CPS<1,31 cases(38%)≥1 and<20,and 42 cases(51%)≥20.Cases with perineural invasion had lower CPS(χ^(2)=6.35,P=0.042).Among 82 matched lymph node metastatic lesions,9 cases(11%)had CPS<1,38 cases(46%)≥1 and<20,and 35 cases(43%)≥20.The CPS of 27 pairs(33%)of primary and metastatic lesions were discordant.The statistical results showed that the Kappa value of consistency evaluation was 0.446,indicating that the consistency of PD-L1 CPS in primary and metastatic lesions of OSCC was medium.Conclusions There are differences in PD-L1 expression between the primary lesion of OSCC and cervical lymph node metastatic lesions,and the consistency is medium.In the routine practice,lymph node metastatic lesions should be carefully used to replace the primary lesion for PD-L1 CPS evaluating.

关 键 词：癌 鳞状细胞 口腔鳞状细胞癌 原发灶 颈部淋巴结 转移灶 PD-L1表达 联合阳性评分 

分 类 号：R739.8[医药卫生—肿瘤]