三阴性乳腺癌中VISTA、PD-L1表达与临床病理特征及预后的相关性

Correlation of VISTA and PD-L1 expression with the clinicopathological features and prognosis in triple-negative breast cancer

目的探讨三阴性乳腺癌(triple-negative breast cancer,TNBC)中VISTA、PD-L1的表达与临床病理特征及预后的相关性。方法收集南京医科大学第一附属医院2016—2018年非特殊类型的TNBC标本90例,免疫组织化学方法检测肿瘤细胞及免疫细胞中VISTA、PD-L1的表达,分析其表达与临床病理特征的关系,并探究各因素与患者预后的相关性。结果肿瘤细胞VISTA表达的阳性率为17.8%(16/90),其表达与Ki-67阳性指数(P=0.02)、肿瘤浸润淋巴细胞(tumor-infiltrating lymphocyte,TIL)数目(P<0.01)呈正相关。免疫细胞中VISTA表达的阳性率为71.1%(64/90),与肿瘤大小(P=0.02)、T分期(P=0.04)负相关,与TIL数量(P<0.01)、CD8+T细胞比例(P=0.03)、Ki-67阳性指数(P=0.02)呈正相关。免疫细胞中PD-L1表达的阳性率为17.8%(16/90),PD-L1表达与组织学分级(P=0.04)、Ki-67阳性指数(P=0.02)、TIL数量(P<0.01)正相关。TNBC患者的免疫细胞中,VISTA比PD-L1阳性率更高(P<0.01)。90例TNBC患者中,85例获得完整随访,其中8例复发或转移,2例因乳腺癌复发转移而死亡。结论在TNBC的免疫细胞中,VISTA的表达率比PD-L1更高;免疫细胞中VISTA的表达与T分期负相关;VISTA可能是免疫治疗的有效靶点。

Objective To investigate the expression of VISTA and PD-L1 in triple-negative breast cancer(TNBC)and to explore its relationship with clinicopathologic features and prognosis.Methods Ninety TNBC patients who underwent surgical resections between 2016 to 2018 in Jiangsu Province Hospital were selected.The expression of VISTA and PD-L1 in both tumor cells and immune cells was evaluated by immunohistochemistry,and the relationship with clinicopathologic parameters and prognosis was analyzed.Results VISTA was expressed in 17.8%(16/90)of the tumors.The expression of VISTA in tumor cells was related to a higher Ki-67 proliferation index(P=0.02)and higher number of tumor-infiltrating lymphocytes(TIL,P<0.01).VISTA was expressed in 71.1%(64/90)of the immune cells and the expression correlated with smaller tumor size(P=0.02),lower T stage(P=0.04),higher number of TIL(P<0.01),higher number of CD8+T cells(P=0.03)and higher Ki-67 proliferation index(P=0.02).PD-L1 was expressed in 17.8%(16/90)of the immune cells and the expression correlated with higher histologic grade(P=0.04),higher Ki-67 proliferation index(P=0.02)and higher number of TIL(P<0.01).VISTA expression was higher in immune cells within TNBC patients than PD-L1(P<0.01).Among 90 TNBC patients,complete follow-up was obtained in 85 patients,8 of whom had recurrences or metastasis after surgery,and two patients cases died of recurrences or metastasis.Conclusions The expression rate of VISTA is higher than that of PD-L1 in TNBC.The expression of VISTA in immune cells predicts a lower T stage.VISTA may act as an effective immunotherapy target.