三阴性乳腺癌组织PD-1/PDL-1表达与肿瘤临床特征和T淋巴细胞免疫功能的相关性分析

Correlation Analysis of PD-1/PDL-1 Expression in Triple Negative Breast Cancer with Clinical Features of Tumor and Immune Function of T Cells

目的探讨三阴性乳腺癌(triple negative breast cancer,TNBC)患者肿瘤组织程序性死亡分子-1(PD-1)/程序性死亡配体-1(PDL-1)的表达水平,及其与肿瘤临床特征和T淋巴细胞免疫功能的相关性。方法选择2018年6月—2020年2月入我院经病理确诊的TNBC患者76例(TNBC组),非TNBC患者124例(非TNBC组),乳腺良性肿瘤50例(良性组)。分别检测3组肿瘤组织中PD-1和PDL-1表达,T淋巴细胞亚群CD4+、CD8+和调节性T细胞(Treg)百分比;探讨3组PD-1和PDL-1定量表达与CD4+、CD8+和Treg百分比的相关性;分析TNBC组PD-1和PDL-1表达与肿瘤临床特征的关系。结果TNBC组PD-1和PDL-1阳性表达率和定量表达水平均明显高于非TNBC组和良性组,非TNBC组亦明显高于良性组,差异有统计学意义(P<0.05)。TNBC组CD4+、CD8+和Treg百分比均明显低于非TNBC组和良性组,非TNBC组亦明显低于良性组,差异有统计学意义(P<0.05)。相关分析发现,PD-1和PDL-1定量表达水平与CD4+、CD8+和Treg百分比呈负相关性(P<0.01)。TNBC组PD-1和PDL-1阳性表达率在肿瘤TNM分期、组织学分级和淋巴结转移方面有显著差异(P<0.05或P<0.01)。结论TNBC患者肿瘤组织中PD-1/PDL-1异常高表达可能与T淋巴细胞免疫功能抑制和肿瘤恶性生物学行为有关。

Objective To investigate the expression of programmed death molecule-1(PD-1)/programmed death ligand-1(PDL-1)in tumor tissue of triple negative breast cancer(TNBC)patients and its correlation with tumor clinical features and T lymphocyte immune function.Methods From June 2018 to February 2020,76 TNBC patients(TNBC group),124 non-TNBC patients(non-TNBC group)and 50 benign breast tumor(benign group)that were pathologically confirmed in our hospital were enrolled in this study.The PD-1 and PDL-1 expression in tumor tissue,and percentage of T lymphocyte subsets including CD4+,CD8+and regulatory T cells(Treg)were detected in three groups of tumor tissues.The correlation of PD-1 and PDL-1 quantitative expression with percentage of CD4+,CD8+and Treg,as well as the relationship of PD-1 and PDL-1 expression to clinical characteristics of tumor in TNBC group was explored.Results The positive expression rates and quantitative expression levels of PD-1 and PDL-1 in TNBC group were significantly higher than those in non-TNBC group and benign group,and the levels and rates in non-TNBC group was significantly higher than those in the benign group(P<0.05).The percentage of CD4+,CD8+and Treg in TNBC group was significantly lower than that in non-TNBC group and benign group,and the percentage in non-TNBC group was significantly lower than that in the benign group(P<0.05).The correlation analysis showed that there was a negative correlation of PD-1 and PDL-1 quantitative expression levels with percentage of CD4+,CD8+and Treg(P<0.01).PD-1 and PDL-1 positive expression rates in TNBC group were significantly different with respect to tumor TNM stage,histological grade and lymph node metastasis(P<0.05 or P<0.01).Conclusion The abnormal high expressions of PD-1/PDL-1 in tumor tissues of TNBC patients may be related to the immunosuppression of T lymphocyte and the malignant biological behavior of tumor.