乳腺癌组织PD1、PDL1表达变化及其与患者临床病理参数和预后的关系

Change in expression of PD1 and PDL1 of breast cancer tissues and their correlations with the clinicopathological characteristics and prognosis of patients

目的探讨程序性死亡蛋白1(PD1)、程序性死亡蛋白配体1(PDL1)在乳腺癌发生、发展中的作用。方法选择乳腺癌患者93例,取手术切除的乳腺癌组织及其癌旁正常组织,采用免疫组化法检测PD1、PDL1表达。分析PD1、PDL1阳性表达与患者临床病理参数和预后的关系。结果乳腺癌组织及其癌旁正常组织PD1阳性表达率分别为79.57%(74/93)、48.39%(45/93),PDL1阳性表达率分别为79.57%(74/93)、22.58%(21/93),二者比较P均<0.01。乳腺癌组织PD1阳性表达与患者年龄、绝经状态、肿瘤直径、临床分期和肿瘤部位无关(P均>0.05),与组织学分级和淋巴结转移有关(P均<0.05);PDL1阳性表达与患者年龄、绝经状态、肿瘤大小、淋巴结转移和肿瘤部位无关(P均>0.05),与组织学分级和临床分期有关(P均<0.05)。乳腺癌组织PD1、PDL1阳性表达者术后生存时间分别为(29.81±1.08)、(30.49±1.04)个月,PD1、PDL1阴性表达者分别为(34.74±1.23)、(34.05±1.37)个月;乳腺癌组织PD1、PDL1阳性表达者术后3年总生存率分别为59.46%(44/74)、60.81%(45/74),PD1、PDL1阴性表达者分别为94.74%(18/19)、84.21%(17/19)。乳腺癌组织PD1、PDL1阳性表达者术后生存时间和术后3年生存率均低于PD1、PDL1阴性表达者(P均<0.05)。结论乳腺癌组织PD1、PDL1高表达,其表达变化与肿瘤进展和不良预后有关。

Objective To detect the role of expression of programmed death protein 1（ PD1） and programmed deathligand 1（ PDL1） in the occurrence and development of breast cancer tissues. Methods Immunohistochemical method was used to detect the expression of PD1 and PDL1 in 93 cases of breast invasive ductal cancer tissue samples and adjacent normal breast tissue samples,and the relationship between the expression of PD1 and PDL1 in the cancer tissues and their clinicopathological characteristics and prognosis was analyzed. Results The positive rates of PD1 and PDL1 in the cancer tissues [79. 57%（ 74/93） and 79. 57%（ 74/93） ] was much higher than the those of the adjacent normal breast tissues[48. 39%（ 45/93） and 22. 58%（ 21/93） ]（ all P〈0. 05）. In the cancer tissues,the expression of PD1 was related to the histological grades and the lymph nodes metastasis（ P〈0. 05）,but not related to the age,menopause status,tumor size,clinical stages or the location（ P〈0. 05）. Meanwhile,the expression of PDL1 was related to the histological grades and clinical stages（ P〈0. 05）,but not related to the age,menopause status,tumor size,lymph nodes metastasis and the location（ P〈0. 05）. The postoperative survival time of patients with PD1 and PDL1 positive expression was（ 29. 81 ±1. 08） and（ 30. 49 ± 1. 04） months,which was（ 34. 74 ± 1. 23） and（ 34. 05 ± 1. 37） months in patients with negative PD1 and PDL1 expression,respectively. The 3-year overall survival rates of breast cancer patients with PD1 and PDL1 positive expression were 59. 46%（ 44/74） and 60. 81%（ 45/74）,respectively,and those with negative PD1 and PDL1 expression were 94. 74%（ 18/19） and 84. 21%（ 17/19）,respectively. The postoperative survival time and 3-year survival rate of patients with PD1 and PDL1 positive expression in the breast cancer tissues were lower than those in patients with PD1 and PDL1 negative expression（ both P〈0. 05）. Conclusion PD1 and PDL1 are highly expressed in the breast cancer tissues,and their expression changes are associated with the tumor progression and poor prognosis.