PD-L1、CD163和CD8在淋巴细胞为主型乳腺原发癌及淋巴结转移癌中的表达及意义  

Expression and significance of PD-L1,CD163 and CD8 in primary cancer andpaired lymph node metastatic cancer of lymphocyte-predominant breast cancer

作　　者：陈妙玲 杨月 张会芳 韩玉贞[1] CHEN Miaoling;YANG Yue;ZHANG Huifang;HAN Yuzhen(Department of Pathology,Binzhou Medical University Hospital,Binzhou 256600,China)

机构地区：[1]滨州医学院附属医院病理科,滨州256600

出　　处：《临床与实验病理学杂志》2024年第5期520-525,530,共7页Chinese Journal of Clinical and Experimental Pathology

基　　金：山东省自然科学基金(ZR2010HM096)。

摘　　要：目的探讨淋巴细胞为主型乳腺癌(lymphocyte-predominant breast cancer,LPBC)中程序性死亡配体-1(programmed death-ligand 1,PD-L1)、CD163和CD8的表达和预后价值,并比较原发癌和相应淋巴结转移癌中PD-L1、CD163和CD8的表达。方法收集具有完整病理资料的LPBC 82例,采用免疫组化EnVision法检测82例原发癌及23例相应淋巴结转移癌中PD-L1、CD163和CD8的表达,并分析其与临床病理特征及预后的相关性,以及原发癌和转移癌的表达差异。结果原发癌中PD-L1在肿瘤细胞(tumor cell,TC)和免疫细胞(immune cell,IC)的阳性率分别为25.61%(21/82)、79.27%(65/82),其中TC-PD-L1在组织学分级Ⅱ和Ⅲ级的阳性率分别为18.00%(9/50)、37.50%(12/32),TC-PD-L1的表达与组织学分级有关(P<0.05);IC-PD-L1在肿瘤最大径≤2 cm和>2 cm的阳性率分别为66.67%(18/27)、85.45%(47/55),在Ki67≤20%和>20%的阳性率分别为60.00%(12/20)、85.48%(53/62),IC-PD-L1的表达与肿瘤最大径、Ki67有关(P均<0.05);TC-PD-L1的表达与CD8+瘤内肿瘤浸润淋巴细胞(intratumoral tumor-infiltrating lymphocytes,iTILs)密度呈正相关(r=0.277,P<0.05),IC-PD-L1的表达与CD163呈正相关(r=0.259,P<0.05);CD163高表达与较短的无瘤生存期(disease free survival,DFS)显著相关(P<0.05)。原发癌和淋巴结转移癌的TC-PD-L1和IC-PD-L1表达一致率分别为82.61%(19/23)、47.82%(11/23),差异无统计学意义(P均>0.05);CD163和CD8+iTILs均存在显著差异(P均<0.05)。结论原发癌中PD-L1的表达与不良预后的临床病理特征相关,CD163高表达提示预后差。LPBC原发癌和相应淋巴结转移癌的肿瘤免疫微环境存在差异,对转移癌PD-L1的重新评估或有助于指导临床进行肿瘤免疫治疗。Purpose To investigate the expression and prognostic value of programmed death-ligand 1(PD-L1),CD163 and CD8 in lymphocyte-predominant breast cancer(LPBC),and to analyze the expression of PD-L1,CD163 and CD8 in primary cancer and corresponding lymph node metastatic cancer.Methods LPBC with complete pathological data were selected.Immunohistochemical EnVision method was used to detect the expression of PD-L1,CD163 and CD8 in 82 cases of primary cancer and 23 cases of corresponding lymph node metastatic cancer.Their relationships with clinicopathological features and prognosis were analyzed,and the difference of expression between primary cancer and lymph node metastatic cancer.Results The positive rates of PD-L1 in tumor cell(TC)and immune cell(IC)in primary cancer were 25.61%(21/82)and 79.27%(65/82),respectively.The positive rates of TC-PD-L1 in gradeⅡand gradeⅢwere 18.00%(9/50)and 37.50%(12/32),respectively.The expression of TC-PD-L1 was correlated with the histological grade(P<0.05).The positive rates of IC-PD-L1 in tumor maximum diameter≤2 cm and>2 cm were 66.67%(18/27)and 85.45%(47/55),respectively.The positive rates of IC-PD-L1 in Ki67≤20%and>20%were 60.00%(12/20)and 85.48%(53/62),respectively.The expression of IC-PD-L1 was related to tumor maximum diameter and Ki67(P<0.05).TC-PD-L1 expression was positively correlated with CD8+intratumoral tumor-infiltrating lymphocytes(iTILs)density(r=0.277,P<0.05),and IC-PD-L1 expression was positively correlated with CD163(r=0.259,P<0.05).High expression of CD163 was significantly correlated with shorter DFS(P<0.05).Between primary cancer and lymph node metastatic cancer,the co-expression rates of TC-PD-L1 and IC-PD-L1 were 82.61%(19/23)and 47.82%(11/23),respectively,and the difference was not statistically significant(P>0.05).There were statistically differences of CD163 expression and CD8+iTILs between primary cancer and lymph node metastatic cancer(P<0.05).Conclusion PD-L1 expression in primary cancer is associated with poor clinicopathologic features,and high

关 键 词：乳腺肿瘤 淋巴细胞为主型乳腺癌 淋巴结转移 PD-L1 CD163 

分 类 号：R737.9[医药卫生—肿瘤]