PD-L1在头颈部高分化鳞状细胞癌中的表达模式及临床病理学意义  

Expression pattern and clinicopathological significance of PD-L1 in highly differentiated head and neck squamous cell carcinoma

作　　者：袁杭 王声燕 倪亨吏 邬慧倩 李阳阳 陈耿标[1] 曾弘[1] YUAN Hang;WANG Shengyan;NI Hengli;WU Huiqian;LI Yangyang;CHEN Gengbiao;ZENG Hong(Department of Pathology,Sun Yat-sen Memorial Hospital of Sun Yat-sen University,Guangdong Guangzhou 510120,China)

机构地区：[1]中山大学孙逸仙纪念医院病理科,广东广州510120

出　　处：《现代肿瘤医学》2023年第20期3776-3780,共5页Journal of Modern Oncology

摘　　要：目的:研究高分化头颈部鳞状细胞癌(HNSCC)中程序性死亡受体配体1(PD-L1)的表达情况、肿瘤浸润淋巴细胞(TILs)的分布及临床病理特征。方法:回顾性分析127例高分化HNSCC手术患者的临床病理资料,采用IHC检测PD-L1在癌组织、不典型增生组织及癌旁正常组织中的表达,HE镜下评估TILs的分布情况。结果:PD-L1在高分化鳞状细胞癌的癌细胞或TILs高表达(CPS≥20,约占69.3%)或低表达(1≤CPS<20,约占30.7%);在不典型增生组织中不表达(CPS<1,约占29.9%)或低表达(1≤CPS<20,约占69.2%),个别病例高表达(CPS≥20,约占0.9%);在癌旁正常组织中不表达(CPS<1,约占56%)或散在隐窝上皮或极少数淋巴细胞低表达(CPS=1约占22%;CPS=2约占16%;CPS=5约占6%),差异有统计学意义(P=0.000)。TILs在高分化鳞状细胞癌的癌组织中主要呈重度浸润(低度浸润约占7%,中度浸润约占38.6%,重度浸润约占54.3%);在不典型增生组织中主要呈中度浸润(低度浸润约占5.6%,中度浸润约占52.3%,重度浸润约占42.1%);在癌旁正常组织中主要呈低度浸润(低度浸润约占88%,中度浸润约占11%,重度浸润约占1%);差异有统计学意义(P=0.000)。高分化鳞状细胞癌的癌组织中PD-L1的表达与肿瘤浸润淋巴细胞(TILs)呈正相关(P=0.018)。在表达模式上,PD-L1在癌旁正常组织中不表达或少数表达于隐窝上皮及周围淋巴细胞;在不典型增生组织中不表达或低表达于上皮的基底部及周围淋巴细胞;在极高分化鳞状细胞癌(4例疣状癌)及早期浸润性癌,主要表达于浸润前沿的癌细胞,表达部位有明显的极向性;在广泛浸润的鳞状细胞癌中PD-L1表达极向性不明显。癌组织中TILs多聚集围绕在浸润性癌巢周围,PD-L1高表达。癌旁正常组织中淋巴细胞少,其中仅见极少数PD-L1阳性的淋巴细胞。结论:PD-L1和TILs在高分化鳞状细胞癌中高表达及其相关性,反映了肿瘤浸润过程与肿瘤微环境的相互作用,其特Objective:To study the expression of programmed death receptor ligand 1(PD-L1),the distribution of tumor infiltrating lymphocytes(TILs)and the clinicopathological characteristics in highly differentiated head and neck squamous cell carcinoma(HNSCC).Methods:The clinicopathological data of 127 patients with highly differentiated HNSCC were retrospectively analyzed.The expression of PD-L1 in cancer tissue,atypical hyperplasia tissue and normal tissues adjacent to cancer was detected by IHC,and the distribution of TILs was evaluated under HE microscope.Results:PD-L1 was highly expressed(CPS≥20,accounting for 69.3%)or lowly expressed(1≤CPS<20,accounting for 30.7%)in cancer cells or TILs of highly differentiated squamous cell carcinoma.PD-L1 had no expression(CPS<1,accounting for 29.9%)or low expression(1≤CPS<20,accounting for 69.2%)in atypical hyperplasia tissues,and high expression(CPS≥20,accounting for 0.9%)in individual cases.There was no expression in normal tissues adjacent to cancer(CPS<1,accounting for about 56%)or scattered in crypt epithelium or very few lymphocytes with low expression(CPS=1,accounting for about 22%.CPS=2,accounting for about 16%.CPS=5,accounting for about 6%),and the difference was statistically significant(P=0.000).TILs in highly differentiated squamous cell carcinoma mainly showed severe invasion(low invasion accounted for 7%,moderate invasion accounted for 38.6%,and severe invasion accounted for 54.3%).In atypical hyperplastic tissues,it mainly presented moderate infiltration(low infiltration accounted for 5.6%,moderate infiltration accounted for 52.3%,and severe infiltration accounted for 42.1%).In normal tissues adjacent to cancer,it mainly presented low degree infiltration(low degree infiltration accounted for 88%,moderate infiltration accounted for 11%,and severe infiltration accounted for 1%).The difference was statistically significant(P=0.000).The expression of PD-L1 in highly differentiated squamous cell carcinoma was positively correlated with tumor infiltrating lymphocyt

关 键 词：头颈部 高分化鳞状细胞癌 PD-L1 肿瘤浸润淋巴细胞 表达模式 诊断 

分 类 号：R739.91[医药卫生—肿瘤]