外周血PD⁃1/PD⁃L1在乳腺癌中的研究进展

Advances of the expression of PD⁃1/PD⁃L1 in peripheral blood in breast cancer

2019年阿替利珠单抗获批应用于无法手术的程序性死亡受体-配体1(PD-L1)阳性三阴型乳腺癌,并以组织中PD-L1阳性表达作为应用此种抑制剂的指征。现有研究已证明程序性死亡受体-1(PD-1)与PD-L1的表达能够提示肿瘤的大小、分级、分期、预后,反映机体的免疫状态以及对免疫抑制剂治疗的敏感性和疗效。但临床上仍然需要一种可重复性较高的手段替代组织活检对机体免疫状态进行实时监测以随时调整临床用药。因此,寻找其他形式的PD-1/PD-L1检测替代组织病理学检查成为研究重点。外周血的检测不失为一种替代方式。本文将就目前乳腺癌患者外周血中血浆可溶性PD-1(sPD-1)与血浆可溶性PD-L1(sPD-L1)、外泌体PD-1与外泌体PD-L1、循环肿瘤细胞(CTC)PD-1与PD-L1及循环淋巴细胞PD-1与PD-L1等不同形式PD-1与PD-L1检测的研究现状、实际意义及其与病理组织中PD-1/PD-L1表达性质的关联做了简要综述,并指出乳腺癌中该领域的研究方向及面临的挑战,为临床PD-1/PD-L1检测新手段提供新的方向和思路。

Atezolizumab was approved to be applied to treating patients with inoperable triple⁃negative breast malignant tumor which was assured to be PD⁃L1 positive by tissue biopsy.Generally,the expression of PD⁃1/PD⁃L1 in the tissue microenvironment is used as an indication of whether to use this inhibitor in clinical practice.A number of clinical studies have shown that the expression of PD⁃1/PD⁃L1 can imply the tumor staging,prognosis,and reflect the immune status of the individual,as well as the sensitivity and efficacy of the immune checkpoint inhibitors.However,tissue biopsy can′t monitor the dynamic change of the expression of immune checkpoint molecules to Adjust clinical medication relevantly.As a result the use of other forms of PD⁃1/PD⁃L1 detection in peripheral blood as an alternative to histopathological examination has become a research focus.This article will briefly review the current detection methods of PD⁃1 and PD⁃L1 in the peripheral blood in patients with breast tumors,including plasma soluble PD⁃1/PD⁃L1(sPD⁃1/sPD⁃L1);exosomal PD⁃1/PD⁃L1;circulating tumor cells PD⁃1/PD⁃L1 and circulating lymphocytes PD⁃1/PD⁃L1,point out the prospect and challenge in breast cancer in this field and provide new directions for new clinical PD⁃1/PD⁃L1 detection methods.