食管鳞状细胞癌患者术前程序性死亡受体1、程序性死亡配体1与临床病理参数及术后早期复发转移之间的关系

Relationship between preoperative programmed death receptor 1, programmed death ligand 1 and clinical pathological parameters, early postoperative recurrence and metastasis in Patients with Esophageal Squamous Cell Carcinoma

目的探讨食管鳞状细胞癌患者术前程序性死亡受体1(programmed death 1,PD-1)、程序性死亡配体1(programmed deathreceptor-1 ligand,PD-L1)与临床病理参数及术后早期复发转移之间的关系.方法回顾性分析2015年1月至2017年1月解放军联勤保障部队第九一○医院医院收治的58例行根治性食管鳞状细胞癌手术患者的石蜡组织标本结果和临床病理资料.采用SP免疫组化染色法测定食管鳞状癌组织及正常食管黏膜中PD-1、PD-L1表达情况,比较正常食管黏膜、食管鳞状细胞癌组织PD-1、PD-L1阳性表达率,分析PD-1、PD-L1与性别、年龄、家族史、肿瘤浸润深度、分化程度、淋巴结有无转移、TNM分期的关系,术后通过随访统计早期(≤1年)的复发转移情况,分析复发转移组和非复发转移组患者的食管鳞状细胞癌组织中PD-1、PD-L1的表达情况.结果食管鳞状细胞癌中PD-1阳性表达率为37.93%(22/58),明显高于正常食管黏膜的15.52%(9/58),差异有统计学意义(χ^2=7.440,P=0.006);食管鳞状细胞癌中PD-L1阳性表达率为43.10%(25/58),明显高于正常食管黏膜的18.97%(11/58),差异有统计学意义(χ^2=7.894,P<0.05).不同浸润深度、TNM分期的PD-L1阳性表达率差异有统计学意义(P<0.05). 58例行根治性食管鳞状细胞癌手术患者随访6~12个月,共有14例患者出现复发转移,发生率为24.14%(14/58).术后复发组PD-1阳性表达率为42.86%(6/14),未复发组为 36.36%(16/44),两者比较差异无统计学意义(χ^2 =0.190,P>0.05);术后复发组PD-L1阳性表达率71.43%(10/14),未复发组为34.09%(15/44),两者比较差异有统计学意义(χ^2=6.037,P<0.05).结论食管鳞状细胞癌患者的癌组织PD-1、PD-L1呈高表达,其中PD-L1与食管鳞状细胞癌疾病发生、进展关系密切,也是影响术后早期复发转移的重要指标,可作为早期诊断及治疗的新靶点.

Objective To investigate the relationship between programmed death 1 (PD-1), programmed death receptor-1 ligand (PD-L1)and clinical pathological parameters, early postoperative recurrence and metastasis in patients with esophageal squamous cell carcinoma. Methods The retrospectively analyze of Paraffin tissue specimens and clinical pathology data in 58 Patients undergoing radical esophageal squamous cell carcinoma surgery from January 2015 to January 2017 in the 910 hospital of PLA Joint Service Support force were performed.Expression of PD-1 and PD-L1 in esophageal squamous cell carcinoma and normal esophageal mucosa were detected by SP immunohistochemical staining.The positive expression rates of PD-1 and PD-L1 in normal esophageal mucosa and esophageal squamous cell carcinoma were compared.the relationship between PD-1 and PD-L1 and gender, age, family history, depth of tumor invasion, degree of differentiation, lymph node metastasis, and TNM staging were analyzed.Follow-up was performed by outpatient consultation and telephone consultation.The recurrence and metastasis of early postoperative (≤1 year)was analyzed.The PD-1 and PD-L1 in esophageal squamous cell carcinoma were analyzed in patients with recurrent metastasis and non-relapsing and metastasis. Results The positive expression rate of PD-1 in esophageal squamous cell carcinoma was 37.93%(22/58), which was significantly higher than that in normal esophageal mucosa 15.52%(9/58). The difference was statistically significant (χ^2=7.440, P=0.006). The positive expression rate of PD-L1 in esophageal squamous cell carcinoma was 43.10%(25/58), which was significantly higher than that of normal esophageal mucosa 18.97%(11/58). The difference was statistically significant (χ^2=7.894, P=0.005). There was a difference in the positive expression rate of PD-L1 between different infiltration depth and TNM stage, P<0.05.58 patients who underwent radical esophageal squamous cell carcinoma had been followed up for 6-12 months.A total of 14 patients had recurrence and metastasis, the incidence rate was 24.14%.The positive expression rate of PD-1 in the recurrence group was 42.86%(6/14), and that in the non-recurrent group was 36.36%(16/44). The difference was not statistically significant,(χ^2=0.190, P>0.05). The positive expression rate of PD-L1 in the recurrence group was 71.43%(10/14), and that in the non-recurrent group was 34.09%(15/44). The difference was statistically significant,(χ^2=6.037, P<0.05). Conclusion The expression of PD-1 and PD-L1 in cancer tissues of patients with esophageal squamous cell carcinoma is highly expressed.PD-L1 is closely related to the occurrence and progression of esophageal squamous cell carcinoma, and it is also an important index affecting early recurrence and metastasis.Which can be selected as a new target for early diagnosis and treatment.