PD-L1在胆囊癌组织中的表达及其与临床病理因素的相关性研究

Evaluation of programmed death-ligand 1expression and the clinicopathologic association in gallbladder cancer patients

[目的]探讨程序性死亡受体-配体1(programmed death-ligand 1,PD-L1)在胆囊癌中的表达及其与临床病理因素的相关性和预后价值。[方法]应用免疫组化染色EnVision二步法检测PD-L1在41例胆囊癌及癌旁正常组织中的表达,分析其与胆囊癌患者临床病理因素的相关性。[结果]PD-L1在癌旁正常胆囊黏膜及胆囊癌中的表达分别为0(0/41)及34.14%(14/41),2组之间的表达存在显著性差异(P<0.001)。PD-L1的表达与淋巴血管侵犯、淋巴结转移、远处转移相关(P<0.05)。单因素分析结果显示PD-L1高表达、肿瘤分化程度、淋巴血管侵犯、神经纤维侵犯、pT分期、N分期及远处转移与胆囊癌患者的不良预后有相关性(P<0.05)。多因素分析显示,分化程度、pT分期、神经纤维侵犯及远处转移是影响患者预后的独立危险因素(P<0.05)。Kaplan-Meier生存分析显示,胆囊癌患者的总生存时间随着PD-L1的表达增强显著下降(P<0.05)。[结论]PD-L1的高表达与胆囊癌患者的预后密切相关,与拮抗PD-L1的免疫治疗可能成为胆囊癌的潜在治疗靶点。

[Objective]To investigate the expression of programmed death-ligandl （ PD-L1） in gallbladder carcinoma and its correlation with clinicopathological features. [Methods]The expression of PD-LI expression was performed on 41 cases of gallbladder carcinoma and adjacent normal tissues by using immunohis-tochemical staining. Correlations with clinicopathological variables were analyzed retrospectively. [Results] The positive rate of PD-L1 in specimens of adjacent normal tissues and gallbladder carcinoma was 0（0/41） and 34. 14% （14/41）respectively. There was a significant difference between the two groups（P〈0.001）. The expression of PD-L1 was significantly associated with lymphovascular invasion, N stage, and distant metastasis（P 〈0. 05 ）. Univariate analysis showed that high expression of PD-L1,tumor differentiation, lymphovascular invasion,perineural invasion,pT stage,N stage and distant metastasis were prognostic factors for poorer overall survival of gallbladder cancer patients（P〈0.05）. Multivariate analysis showed that tumor differentiation, pT stage, perineural invasion and distant metastasis were independent poor risk fac-tors of gallbladder cancer（P〈0.05）. Kaplan-Meier survival analysis showed that the overall survival rate of gallbladder cancer patients decreased significantly with the increase of PD-L1 expression（P〈0.05）. [Conclusion]The expression of PD-L1 has significant role on the prognosis of gallbladder carcinoma pa- tients. Blocking PD-L1 may be become a potential therapeutic target for immunotherapy in gallbladder cancer.