PD-L1和肿瘤浸润淋巴细胞相关标志物在宫颈癌组织中的表达及临床病理意义

Expression of PD-L1 and tumor infiltrating lymphocyte markers in uterine cervical carcinoma

目的探讨宫颈癌组织PD-L1、CD4、CD8、CXCL-13表达情况并分析其临床病理意义。方法收集解放军总医院第七医学中心2019年1月至2021年12月根治切除宫颈癌组织标本77例,用免疫组织化学方法检测PD-L1、CD4、CD8、CXCL-13表达,分析各项指标与患者临床病理参数的关系。结果77例宫颈癌(鳞癌59例,腺癌18例),患者年龄29~69岁,平均(49.4±9.8)岁。免疫组织化学结果示,PD-L1在宫颈鳞癌与腺癌组织均有不同程度表达,其表达差异与病理组织学类型有关(χ^(2)=4.975,P=0.026);在癌巢内与癌旁间质中均见CD4^(+)、CD8^(+)、CXCL-13^(+)肿瘤浸润淋巴细胞(TIL),宫颈癌组织PD-L1表达与癌巢内CD4^(+)、癌巢内及癌旁间质内CD8^(+)、CXCL-13^(+)TIL数量中度相关,但与患者年龄、有无脉管浸润、有无淋巴结转移及国际妇产科联盟分期无关(P>0.05)。结论宫颈癌组织PD-L1高表达与癌巢内及癌旁间质中TIL数量增多密切相关,提示PD-L1和TIL可能对预测宫颈癌患者的免疫治疗反应有重要参考价值。

Objective To investigate the expression of PD-L1,CD4,CD8 and CXCL-13 in cervical carcinoma,and their clinicopathological significance was analyzed.Methods A total of 77 patients with cervical carcinoma in the Seventh Medical Center,PLA General Hospital from January 2019 to December 2021 were included.All patients received radical surgical resection in the Seventh Medical Center of Chinese PLA General Hospital.The expression of PD-L1,CD4,CD8 and CXCL-13 was detected by immunohistochemical(IHC)method.The correlation between IHC markers and patients′clinicopathological parameters was analyzed.Results There were 59 cases of squamous cell carcinoma and 18 cases of adenocarcinoma(ranging from 29 to 69 years)with an average of(49.4±9.8)years.PD-L1 was expressed in different degrees in cervical squamous cell carcinoma and adenocarcinoma(χ^(2)=4.975,P=0.026);CD4^(+),CD8^(+)and CXCL-13^(+)tumor infiltrating lymphocytes(TIL)were observed in the carcinoma cell nests and peritumoral stroma.PD-L1 expression in cervical carcinoma was moderately correlated with the number of CD4^(+)TIL in the carcinoma nests,and the number of CD8^(+),CXCL-13^(+)TIL infiltration in the carcinoma nests and stroma,but not to the patient′s age,histologic differentiation,presence or absence of vascular invasion,presence or absence of lymph node metastasis and FIGO stage(P>0.05).Conclusions The high expression of PD-L1 in cervical carcinoma tissues is closely related to the number of TIL in the carcinoma nests and peritumor stroma,suggesting that they may have important reference value for predicting the response to immunotherapy in patients with cervical carcinoma.