胃癌组织中PD-L1的表达及其与预后的关系

Expression of the costimulatory molecule PD-L1 in tissues of gastric carcinoma and its relation with prognosis

为探讨共刺激分子PD-L1在胃癌组织中的表达及其临床意义。用免疫组织化学方法检测102例胃癌和10例胃腺瘤PD-L1的表达,并对其表达与患者年龄、性别、胃癌部位、肿瘤大小、组织类型、肿瘤浸润深度、分化程度、淋巴结转移等进行相关分析。结果:胃腺瘤组织和正常胃组织不表达PD-L1分子,胃癌组织中PD-L1呈阳性表达,表达阳性率为42.2%;PD-L1分子在胃癌组织中的表达与胃癌患者年龄、性别、肿瘤部位、组织学类型无关(P>0.05),与肿瘤大小、肿瘤的浸润深度、淋巴结转移及预后有关。当肿瘤大于5cm(P<0.05)、肿瘤浸润达深肌层、淋巴结转移阳性、生存期<2年时,PD-L1表达阳性率明显升高(P<0.01)。多变量分析还显示,PD-L1分子可作为评估胃癌预后的独立因素。胃癌组织PD-L1分子的检测有助于胃癌预后的判断和作为个体化治疗选择的生物学指标。

The expression of the costimulatory molecule PD-L1 in tissues of gastric carcinoma and its relation to the prognosis were investigated in the present study, in which the expression of PD-L1 was detected by immunohistochemical assay in the cancer tissues of 102 patients with gastric carcinoma and 10 patients with gastric adenoma, and the correlation analysis had been made among the expression of PD-L1 with patient＇s age and sex, size location, histological types, depth of infiltration, degree of differentiation and metastasis to lymph nodes of caners. The results showed that there was no significant expression of PD-L1 in normal gastric tissues as well as in tissues of gastric adenoma, but in case of tissues of gastric carcinoma , the positive rate of PD-L1 expression reached up to 42.2%. No correlation existed between the PD-L1 expression in gastric cancer tissues and age, sex, location and histological types, but significant correlations could be demonstrated with size, depth of infiltration, metastasis to lymph nodes of cancers as well as the prognosis. Especially, when the size of tumors was over 5 cm, in length, it could infiltrate into the deep muscular layer, accompanied with lymph node metastasis and a shorter survival time of less than two years. The analysis of multi-variable reveals that PD-L1 can be regarded as an independent factor in evaluating the prognosis of gastric carcinoma. In conclusion, it is evident the detection of PD-L1 expression on gastric carcinoma will be beneficial to the judgment of prognosis in gastric cancers and the choice of post-operative therapy.