PD-L1在乳腺癌中的表达及其临床病理意义和预后分析

The expression of PD-L1 in breast cancer and its clinicopathological significance and prognostic analysis

目的探讨程序性死亡配体-1(PD-L1)在乳腺癌中的表达及其临床病理意义。方法选取115例乳腺癌患者作为观察组,其中三阴性乳腺癌45例、非三阴性乳腺癌70例;另选取同期40例非乳腺癌患者作为对照组。两组患者的乳腺样本均经手术切除病理证实。比较两组患者的PD-L1阳性表达情况,不同临床病理特征乳腺癌患者的PD-L1表达情况,不同分子分型乳腺癌患者的生存率。结果免疫组织化学染色结果显示,观察组三阴性乳腺癌患者的PD-L1阳性表达率为35.6%(16/45),非三阴性乳腺癌患者的PD-L1阳性表达率为18.6%(14/70),对照组患者的PD-L1阳性表达为0。两组患者的PD-L1阳性表达率比较,差异具有统计学意义(P<0.05)。其中,三阴性乳腺癌患者的PD-L1阳性表达率高于非三阴性乳腺癌患者及对照组,非三阴性乳腺癌患者的PD-L1阳性表达率高于对照组,差异均具有统计学意义(P<0.05)。不同分子分型、PR表达状态、阳性淋巴结个数、TNM分期乳腺癌患者的PD-L1表达情况比较,差异具有统计学意义(P<0.05)。不同分子分型乳腺癌患者的生存率比较,差异具有统计学意义(P<0.05)。非三阴性乳腺癌LuminalA型患者的生存率95.7%高于三阴性乳腺癌患者的71.1%,差异具有统计学意义(P<0.05)。结论PD-L1在不同分子分型乳腺癌中的表达存在明显的差异,其中三阴性乳腺癌中的PD-L1表达率最高;且PD-L1的表达与乳腺癌患者的分子分型、PR表达状态、阳性淋巴结个数以及TNM分期有关,是影响其生存及预后的不良因素。

Objective To discuss the expression of programmed death ligand-1(PD-L1)in breast cancer and its clinicopathological significance.Methods There were 115 patients with breast cancer selected as the observation group,including 45 patients with triple-negative breast cancer and 70 patients with nontriple-negative breast cancer.Another 40 patients with non-breast cancer during the same period were selected as the control group.The breast samples of both groups were confirmed by surgery and pathology.Comparison was made on PD-L1 positive expression between the two groups and among breast cancer patients with different clinicopathological characteristics,and the survival rate of breast cancer patients with different molecular typing.Results The results of immunohistochemical staining showed that the positive expression rate of PD-L1 in patients with triple-negative breast cancer in the observation group was 35.6%(16/45),and the positive expression rate of PD-L1 in patients with non-triple-negative breast cancer was 18.6%(14/70),and the positive expression of PD-L1 in the control group was 0.There was statistically significant difference in positive expression rate of PD-L1 between the two groups(P<0.05).Of which,the positive expression of PD-L1 of patients with triplenegative breast cancer was higher than that of patients with non-triple-negative breast cancer and the control group,and the positive expression of PD-L1 of patients with non-triple-negative breast cancer was higher than that of the control group.All the difference was statistically significant(P<0.05).There was statistically significant difference in expression of PD-L1 among patients with different molecular typing,PR expression status,number of positive lymph nodes,and TNM staging(P<0.05).There was statistically significant difference in survival rate among patients with different molecular typing(P<0.05).The survival rate 95.7% of patients with Luminal A non-triple-negative breast cancer was higher than 71.1% of patients with triple-negative breast cancer,and the difference was statistically significant(P<0.05).Conclusion The expression of PD-L1 in different molecular typing of breast cancer is significantly different,among which the expression of PD-L1 in triple-negative breast cancer is the highest,and the expression of PD-L1 is significantly correlated with molecular typing,PR expression status,number of positive lymph nodes and TNM staging,which is an adverse factor affecting their survival and prognosis.