肺腺癌患者胸水肿瘤细胞PD-L1/TTF-1表达及应用分析  

The Expression and Application of PD-L1/TTF-1 Immunohistochemical Double Stain in Pleural Fluid Tumor Cells in Patientswith Lung Adenocarcinoma

作　　者：刘菲菲[1] 姚健楠 谷雨妹 赵宏颖[1] 曹勍[1] 金木兰[1] 李雪[1] LIU Feifei;YAO Jiannan;GU Yumei;ZHAO Hongying;CAO Qing;JIN Mulan;LI Xue(Department of Pathology,Beijing Chaoyang Hospital,Capital Medical University,Beijing 100020,China)

机构地区：[1]首都医科大学附属北京朝阳医院病理科,北京100020

出　　处：《标记免疫分析与临床》2024年第3期405-409,420,共6页Labeled Immunoassays and Clinical Medicine

基　　金：北京市科技计划-首都临床特色诊疗技术研究及转化应用(编号:Z221100007422109)。

摘　　要：目的探讨肺腺癌患者胸水肿瘤细胞程序性细胞死亡配体1(PD-L1)/甲状腺转录因子1(TTF-1)、PD-L1免疫组化染色的表达及与组织标本PD-L1表达一致性及其应用研究。方法选取2021年1月至2023年4月间首都医科大学附属北京朝阳医院收治的符合入组条件的50例肺腺癌患者为研究对象,比较同一病例组织标本中肿瘤细胞的PD-L1表达和胸水细胞蜡块中肿瘤细胞的PD-L1、PD-L1/TTF-1表达情况,评估它们之间表达的一致性。结果50例肺腺癌组织标本PD-L1的表达与患者性别、年龄、标本类型、病灶性质、标本来源和EGFR突变对比差异无统计学意义(P>0.05);胸水细胞蜡块中肿瘤细胞PD-L1/TTF-1免疫组化双染的表达与组织标本PD-L1表达的一致性较好(κ=0.846,P<0.05),明显高于PD-L1免疫组化单染(κ=0.754,P<0.05),与手术或活检切除标本一致性较好(κ=0.90,P<0.05),高于胸腔镜或穿刺小标本(κ=0.82,P<0.05),与原发病灶标本的一致性适中(κ=0.689,P<0.05),与转移病灶标本的一致性较好(κ=0.779,P<0.05)。结论胸水细胞学标本采用PD-L1/TTF-1免疫组化双染与组织标本PD-L1表达一致性较高,细胞蜡块PD-L1/TTF-1双染可在组织不易获取时作为一种有益补充,供临床制定免疫治疗方案参考。Objective To investigate the expression of programmed cell death ligand 1(PD-L1)/thyroid transcription factor 1(TTF-1)and PD-L1 immunohistochemical staining in pleural fluid tumor cells of patients with lung adenocarcinoma,and to evaluate the consistency and application values of PD-L1 expression in tissue samples.Methods Fifty patients with lung adenocarcinoma who were admitted to Beijing Chaoyang Hospital,Capital Medical University from January,2021 to April,2023 and qualified for pleural fluid and tissue matching were selected as the study objects.The expression of PD-L1 in tumor cells of tissue samples from the same case was compared with the expression of PD-L1 and PD-L1/TTF-1 in tumor cells in wax blocks of paired pleural fluid cell.The consistency between the expression of PD-L1 in histological specimens and the expression of PD-L1 and PD-L1/TTF-1 in cell samples was evaluated.Results According to the interpretation criteria of the Chinese Expert Consensus on PD-L1 Immunohistochemical Detection Criteria for Non-Small Cell Lung Cancer(2020),there was no statistical significance in the expression of PD-L in 50 lung adenocarcinoma tissue specimens,when compared among different groups of gender,age,specimen type,lesion nature,specimen source and EGFR mutation(P>0.05);The expression of PD-L1/TTF-1 immunohistochemical double staining of tumor cells in wax block of pleural fluidwas consistent with that of tissue specimen(κ=0.846,P<0.05)was significantly higher than PD-L1 immunohistochemical monostain(κ=0.754,P<0.05)and showed a good consistency with surgical or biopsy removal of specimens(κ=0.90,P<0.05),also higher than that of thoracoscopic or puncture small biopsy specimens(κ=0.82,P<0.05)and showed a moderate consistency with primary lesion(κ=0.689,P<0.05)and a good consistency with metastatic lesions(κ=0.779,P<0.05).Conclusion PD-L1/TTF-1 immunohistochemical double staining of pleural fluid cytological specimens show a high consistency with PD-L1 expression in tissue specimens.PD-L1/TTF-1 double staining

关 键 词：肺肿瘤 腺癌 胸水细胞学 PD-L1 TTF-1 

分 类 号：R734.2[医药卫生—肿瘤]