非小细胞肺癌PD-1PD-L1表达与EGFR基因突变临床特征及预后的相关性

Relationship between PD-1,PD-L1 and EGFR gene mutations,clinical characteristics and prognosis in non-small cell lung cancer

目的探讨非小细胞肺癌患者肺组织中程序性死亡受体-1、程序性死亡配体-1蛋白表达与表皮生长因子受体基因突变、临床特征及预后的相关性,为临床治疗提供参考.方法将117例非小细胞肺癌患者设为研究组,60例良性病例设为对照组,采用免疫组化法检测两组肺组织中程序性死亡受体-1、程序性死亡配体-1蛋白表达,采用荧光聚合酶链式反应法检测研究组表皮生长因子受体基因突变情况,对研究组不同临床特征患者的表皮生长因子受体基因突变及程序性死亡受体-1、程序性死亡配体-1蛋白表达进行分析.结果研究组肺组织中程序性死亡受体-1、程序性死亡配体-1蛋白阳性表达率(35.0%、54.7%)显著高于对照组(19.0%、15.5%)(P<0.05或0.01);研究组女性、高分化患者表皮生长因子受体基因突变率高,肿瘤分期Ⅲ期、Ⅳ期患者程序性死亡配体-1蛋白表达阳性率高,程序性死亡配体-1蛋白表达与表皮生长因子受体基因突变呈显著正相关,程序性死亡配体-1蛋白表达阳性较阴性患者的无进展生存期显著缩短(P<0.05或0.01).结论非小细胞肺癌患者肺组织中程序性死亡受体-1、程序性死亡配体-1蛋白表达阳性率高,程序性死亡配体-1蛋白表达与表皮生长因子受体基因突变显著相关;对表皮生长因子受体基因突变型非小细胞肺癌患者使用表皮生长因子受体的酪氨酸激酶抑制剂治疗,程序性死亡配体-1蛋白表达阳性患者可能预后较差.

Objective To investigate the relationship between PD-1,PD-L1 and EGFR gene mutations,clinical characteristics and prognosis in non-small cell lung cancer and provide reference for clinical treatment.Methods 117 non-small cell lung cancer patients were set as the study group and 60 benign cases were set as the control group.Immunohistochemical method was used to detect the expression of PD-1 and PD-L1 proteins in the lung tissue of the two groups,and EGFR gene mutations in the study group were detected by fluorescent PCR.EGFR gene mutation and PD-1,PD-L1 protein expression in patients with different clinical characteristics in the study group were analyzed.Results The positive expression rates of PD-1 and PD-L1 proteins in the lung tissue of the study group(35.0%,54.7%)were significantly higher than those in the control group(19.0%,15.5%)(P<0.05 or 0.01).Female,well-differentiated patients in study group have high EGFR gene mutation rate.Patients with lymph node metastasis and TNM(Ⅲ+Ⅳ)had a high positive rate of PD-L1 protein expression,and PD-L1 protein expression was significantly positively correlated with EGFR gene mutation.Patients with positive PD-L1 protein expression had significantly shorter progression-free survival than those with negative expression(P<0.05 or 0.01).Conclusions The positive rate of PD-1 and PD-L1 protein expression in lung tissues of patients with nonsmall cell lung cancer is high,and the expression of PD-L1 protein is significantly related to EGFR gene mutations.Patients with non-small cell lung cancer with EGFR gene mutation treated with EGFR-TKI may have poor prognosis in patients with positive PD-L1 protein expression.