PD-1、PD-L1在骨外骨肉瘤中的表达与预后探讨  

The Correlation between expression of PD-1/PD-L1 and clinical prognosis of extraskeletal osteosarcoma

作　　者：许晶晶[1] 孙烨 李菊明[1] 韦永中[1] Xu Jingjing;Sun Ye;Li Juming;Wei Yongzhong(Department of orthopedics,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京医科大学第一附属医院骨科,210029

出　　处：《中华转移性肿瘤杂志》2021年第2期117-122,共6页Chinese Journal of Metastatic Cancer

摘　　要：目的检测分析骨外骨肉瘤(ESOS)标本中PD-1、PD-L1的表达,并结合临床特征与骨肉瘤(OS)对比,探讨其与预后的关系。方法选取2006—2017年间本院骨科就诊的8例ESOS患者及同时期的20例经典OS患者,随访时间为48~108个月,中位时长78个月。利用免疫组化SP法测定所有肿瘤样本中PD-1、PD-L1的表达量,并分析其与患者预后的相关性。结果8例ESOS患者男5例,女3例,平均年龄57.6岁。至随访结束共4例患者出现远处转移,5年生存率为38%。20例OS患者男11例,女9例,平均年龄19.1岁。14例患者术后接受MAP方案化疗,截至随访结束共6例患者出现远处转移,5年生存率为75%。两组5年生存率不同(P<0.05)。ESOS患者的PD-L1阳性表达率略高于经典OS患者(63%∶40%,P>0.05)。PD-L1阳性表达可能与ESOS的疾病进展(转移)相关(P<0.05),但与性别、年龄、肿瘤大小无关(P>0.05)。而在OS患者PD-L1阳性表达与肿瘤分期相关,Ⅲ期OS患者PD-L1阳性率更高(P<0.05)。PD-L1阳性患者预后较PD-L1阴性患者差(P<0.05)。结论与经典OS相比ESOS患者5年生存率较OS差。PD-L1在ESOS中表达上调,且在转移、切缘阳性患者中阳性率进一步增加。PD-L1表达可能与ESOS的预后呈负相关。Objective We aim to detect the expression of PD-1 and PD-L1 in ESOS and OS specimens,and further analyze the correlation between PD-1/PD-L1 expression and prognosis of ESOS.Methods Eight patients with ESOS and 20 patients with classical osteosarcoma were collected from the First Affiliated Hospital of Nanjing Medical University from January 2006 to December 2017.All patients had follow-up ranging from 48 months to 108 months and the middle follow-up time was 78 months.Every tumor specimen was analyzed with immunohistochemistry to examine the expression of PD-1 and PD-L1.The correlation between PD-1/PD-L1 expression and clinical prognosis of ESOS patients was explored.Results In the 8 ESOS patients,5 cases were male and 3 cases were female.The average age was 57.6 years old.Six patients received MAP treatment(high-dose methotrexate,doxorubicin,cisplatin)which was the first-line chemotherapy for classical osteosarcoma after surgery.There were 4 patients with distant metastasis at the end of follow-up,and the 5-year survival rate of ESOS patients was 38%.In the 20 cases of osteosarcoma,there were 11 males and 9 females.The average age was 19.1 years old.Fourteen patients underwent postoperative MAP regimen chemotherapy.A total of 6 patients had distant metastases at the end of follow-up.The 5-year survival rate was 75%.There was a statistically significant difference in 5-year survival rates between ESOS and OS patients(P<0.05).The positive rate of PD-L1 in patients with osteosarcoma(63%)was slightly higher than that in patients with osteosarcoma(40%),but there was no significant statisticaldifference(P>0.05).The positive expression of PD-L1 might be related to the progression(metastasis)of ESOS,but it was not related to gender,age or tumor size.The positive expression of PD-L1 in OS patients was correlated with the stage of tumor.The positive rate of PD-L1 in stageⅢOS patients was significantly higher than that in other OS patients(P<0.05).PD-L1 positive patients had significantly worse prognosis than PD-L1 negat

关 键 词：骨外骨肉瘤 骨肉瘤 PD-L1 PD-1 预后 

分 类 号：R73[医药卫生—肿瘤]