PD-L1在膀胱癌组织中表达及对根治性膀胱切除术后患者预后影响

Expression of PD-L1 in bladder cancer and its effect on prognosis after radical cystectomy

目的探讨PD-L1在膀胱癌中表达及其对根治性膀胱切除术后患者预后的影响。方法选取自2010年12月至2013年1月于北部战区总医院行膀胱根治性切除术的61例患者的肿瘤组织及正常膀胱组织标本为研究对象。采用免疫组织化学方法对肿瘤组织及正常膀胱组织中PD-L1表达情况进行检测,并对患者预后进行随访,根据其临床结果统计分析无复发生存期、疾病特异生存期及总生存期。结果正常膀胱组织PD-L1阳性率为6.7%,明显低于肿瘤组织的45.1%(P<0.05)。膀胱癌肿瘤细胞上PD-L1表达对中位无复发生存期无影响(P>0.05),对肿瘤患者中位总生存期及中位疾病特异生存期有影响(P<0.05)。被肿瘤浸润的免疫细胞上的PD-L1表达对患者无复发生存期、疾病特异生存期及总生存期均无影响(P>0.05)。结论肿瘤细胞PD-L1表达与膀胱癌患者疾病特异生存期及总生存期相关,而与无复发生存期无关。肿瘤细胞上高PD-L1是肿瘤疾病特异生存期及总生存期负面预后标志,可能是肿瘤逃逸或者耐药机制之一。

Objective To investigate the expression of PD-L1 in bladder cancer and its effect on prognosis after radical cystectomy.Methods A retrospective study was performed on 61 cases of tumor tissues and normal bladder tissues which were cut from December 2010 to January 2013.The expression of PD-L1 in tumor tissues and normal bladder tissues was detected by immunohistochemistry,and the prognosis of the patients was followed up.According to the clinical results, the recurrence free survival,disease-specific survival and overall survival were statistically analyzed.Results The positive rate of PD-L1 in normal bladder tissues was 6.7%,which was significantly lower than that in tumor tissues(45.1%),and the difference was statistically significant(P<0.05).PD-L1 expression on bladder cancer tumor cells had no effect on the median recurrence-free survival(P>0.05),and had an effect on the median overall survival and the median disease-specific survival of tumor patients(P<0.05).The expression of PD-L1 on immune cells infiltrated by tumor has no effect on the recurrence free survival,disease-specific survival and overall survival of patients(P>0.05).Conclusion PD-L1 expression in tumor cells is correlated with disease-specific survival and overall survival of bladder cancer patients,while not with recurrence-free survival.High PD-L1 on tumor cells is a marker of tumor disease-specific survival and overall survival negative prognosis,which may be one of the mechanisms of tumor escape or drug resistance.