三阴型乳腺癌中PRAME和PD-L1的表达及临床意义

Expression of PRAME and PD-L1 in triple negative breast cancer and their significance

目的探讨黑色素瘤优先表达抗原(preferentially expressed antigen of melanoma,PRAME)和程序性死亡配体-1(programmed death ligand-1,PD-L1)在三阴型乳腺癌(triple-negative breast cancer,TNBC)中的表达及临床意义。方法收集260例乳腺癌切除标本(TNBC 46例、非TNBC 214例)及正常乳腺组织50例,应用免疫组化EnVision法检测PRAME和PD-L1的表达,分析两者与TNBC临床病理特征的关系,并复习相关文献。结果PRAME在TNBC及非TNBC中的阳性率分别为38.8%和41.3%,差异无显著性(P>0.05),在乳腺癌及正常乳腺组织中的阳性率分别为39.2%和0,差异有显著性(P<0.01),PRAME在乳腺癌中的表达与肿瘤大小、淋巴结转移无相关性。PD-L1在TNBC及非TNBC中的阳性率分别为37.0%和25.0%,差异有显著性(P<0.05),在乳腺癌及正常乳腺组织中的阳性率分别为27.3%和0,差异有显著性(P<0.01),PD-L1在乳腺癌中的表达与淋巴结转移呈正相关,与肿瘤大小无相关性。结论PRAME和PD-L1在乳腺癌组织中的阳性率较高,TNBC中PD-L1阳性率高,其表达与淋巴结转移呈正相关,提示患者预后不良。PRAME和PD-L1可作为TNBC免疫治疗靶点,为临床治疗TNBC提供依据。

Purpose To observe preferentially expressed antigen of melanoma(PRAME)and programmed death ligand-1(PD-L1)in triple negative breast cancer(TNBC)and to explore its significance in TNBC immunotherapy.Methods 260 cases of breast cancer resection specimens were collected,including 46 cases of TNBC,214 cases of non-TNBC and 50 cases of normal breast tissue.The expression of PRAME and PD-L1 was analyzed by immunohistochemistry,and their relationship with the clinicopathological characteristics of each group of patients was analyzed and the literature was reviewed.Results The expression rates of PRAME in TNBC and non-TNBC were 38.8%and 41.3%,respectively,with no significant difference(P>0.05).The expression rates in breast cancer and normal breast tissue were 39.2%and 0,respectively(P<0.01).The expression of PRAME in breast cancer had no significant correlation with tumor size and lymph node metastasis,the expression rates of PD-L1 in TNBC and non-TNBC were 37.0%and 25.0%,respectively,with significant difference(P<0.05);the expression rates in breast cancer and normal breast tissue were 27.3%and 0,respectively,with significant difference(P<0.01);the expression of PD-L1 in breast cancer was positively correlated with lymph node metastasis,but no significant correlation with tumor size.Conclusion PRAME and PD-L1 have a high expression rate in breast cancer tissues.PD-L1 shows a high expression rate in TNBC.PD-L1 expression is positively correlated with lymph node metastasis,indicating a poor prognosis for patients.PRAME and PD-L1 can be used as a target of TNBC immunotherapy and provide a basis for clinical treatment of TNBC.