肺鳞癌组织PD-L1表达变化及其与患者临床病理参数和预后的关系

摘要

目的 探讨程序性死亡配体1(PD-L1)在肺鳞状细胞癌(简称肺鳞癌)发生、发展中的作用.方法 选择肺鳞癌组织90例份、正常肺组织15例份,采用免疫组化法检测PD-L1表达,分析PD-L1表达与患者临床病理参数及预后的关系,应用Cox比例风险回归模型分析影响患者预后的危险因素.结果 肺鳞癌组织PD-L1阳性表达率为66.67％ (60/90),正常肺组织均为阴性表达,二者比较P＜0.01.肺鳞癌组织PD-L1阳性表达与患者性别、年龄、肿瘤直径、吸烟史无关(P均＞0.05),与pTNM分期、淋巴结转移有关(P均＜0.05).PD-L1阳性表达者中位生存时间明显低于阴性表达者(P＜0.05).Cox比例风险回归模型分析显示,PD-L1阳性、淋巴结转移、pTNM分期(Ⅲ期)是影响肺鳞癌预后的独立危险因素(P均＜0.05).结论 肺鳞癌组织PD-L1表达升高,其表达变化可促进肺鳞癌的进展和转移;检测PD-L1表达情况有助于判断患者预后.%Objective To investigate the effect of programmed death ligand-1 (PD-L1) in the occurrence and development of pulmonary squamous-cell carcinoma.Methods PD-L1 protein expression was detected in 90 cases of pulmonary squamous-cell carcinoma and 15 cases of normal lung tissues by immunohistochemistry.The relationship of PD-L1 protein expression with clinicopathological features and prognosis was evaluated,and Kaplan-Meier method was used for the survival analysis.The independent prognostic factors of pulmonary squamous carcinoma were analyzed by Cox regression model.Results The positive expression of PD-L1 was 66.67％ (60/90) in the pulmonary squamous-cell carcinoma tissues,and the expression of PD-L1 in the normal lung tissues was negative (P ＜ 0.05).The expression of PD-L1 was not related with gender,age,smoking history or tumor diameter (all P ＞ 0.05),but was closely correlated with lymph nodes metastasis and pTNM stage (all P ＜ 0.05).The median survival time of patients with PD-L1 positive expression was significantly lower than that of patients with negative expression (P ＜ 0.05).Multivariate Cox regression analysis showed that PD-L1 positive,lymph node metastasis and pTNM stage were independent prognostic factors for patients with lung squamous-cell carcinoma (all P ＜ 0.05).Conclusion The expression of PD-L1 is significantly increased in pulmonary squamous-cell carcinoma,which can promote the progression and metastasis of lung squamous-cell carcinoma and help to determine the prognosis of patients.