PD-L1在胃癌患者手术前后外周血T细胞和单核细胞上的表达及意义

摘要

目的:检测胃癌患者术前术后外周血细胞表面PD-L1的表达,探讨其表达改变及临床意义.方法:收集44例胃癌患者术前术后和18名健康志愿者外周血标本,流式细胞术检测CD3+CD4+T、CD3+CD8+T细胞表面PD-1和PD-L1以及CD14+单核细胞表面PD-L1的表达.结果:与健康志愿者相比,胃癌患者外周血CD4+T和CD8+T细胞表面PD-L1表达无显著差异[(11.1±6.4)% vs (9.8±5.6)%,P=0.4532;(13.9±12.0)% vs (12.0±7.1)%,P=0.5589],而CD14+单核细胞表面PD-L1表达水平显著增加[(29.2±16.7)% vs (17.5±9.7)%,P=0.0073].但胃癌患者术后CD4+T细胞和CD8+T细胞表面PD-L1的表达均显著高于术前水平[(15.8 ±8.2)% vs (11.1 ±6.4)%,P=0.0015;(22.5 ±13.3)% vs (13.9 ±12.0)%,P=0.0002],而术后外周血CD14+单核细胞PD-L1表达水平并无显著变化[(33.8±17.3)% vs(29.2±16.7)%,P=0.0828].同时,胃癌患者手术前后外周血CD4+T和CD8+T细胞表面PD-1的表达无统计学差异[(25.6 ±9.9)% vs (26.9 ±8.9)%,P=0.5055;(26.5±14.6)% vs (29.9±10.4)%,P=0.1187].结论:PD-L1可作为监测原发性胃癌患者的免疫功能和预后评估的有效指标.%Objective:To investigate the expression of PD-L1 in peripheral blood with gastric cancer patients and its clinical significance.Methods:Peripheral blood samples were collected from 44 gastric cancer patients (before and after the surgery) and 18 healthy subjects.The expression of PD-1 and PD-L1 on CD3+CD4+T,CD3+CD8+T cells and CD14+monocytes was detected by flow cy-tometry.Results:The expression of PD-L1 on CD14+monocytes of the gastric cancer patients was significantly higher than that of the healthy control[(29.2±16.7)% vs (17.5±9.7)%,P=0.007 3],while there was no statistical difference on CD4+T cells and CD8+T cells[(11.1±6.4)% vs(9.8±5.6)%,P=0.453 2;(13.9±12.0)% vs(12.0±7.1)%,P=0.558 9].The expression of PD-L1 on CD4+T cells and CD8+T cells in patients with gastric cancer was significantly higher than that before surgery[(15.8 ± 8.2)% vs (11.1±6.4)%,P=0.001 5;(22.5±13.3)% vs(13.9±12.0)%,P=0.000 2].However,no significant change was found on CD14+mononuclear cells[(33.8±17.3)% vs (29.2±16.7)%,P=0.082 8].There was no significant difference in the expression of PD-1 on CD4+T and CD8+T cells before and after surgery[(25.6 ±9.9)% vs (26.9 ±8.9)%,P=0.505 5;(26.5 ±14.6)% vs (29.9 ± 10.4)%,P=0.118 7].Conclusion:PD-L1 can be used as an effective marker to monitor the immune function and prognosis of patients with primary gastric cancer.