食管鳞状细胞癌患者血清PD-L1含量与T淋巴细胞免疫功能的相关性探讨

Correlation between serum PD-L1 content and T lymphocyte immune function in patients with esophageal squamous cell carcinoma

目的:探究食管鳞状细胞癌(esophageal squamous cell carcinoma,ESCC)患者血清程序性死亡配体-1(programmed death-ligand 1,PD-L1)含量与T淋巴细胞免疫功能的相关性。方法:收集2021年08月至2022年01月我院初诊的62例ESCC患者作为ESCC组,对照组29例来自相对健康人群,采用两独立样本Wilcoxon秩和检验比较两组血清PD-L1和T淋巴细胞亚群水平的差异及这些指标在ESCC组不同临床分期中的差异,绘制受试者工作特征曲线(receiver operating characteristic curve,ROC)评价在临床分期中有差异的指标对ESCC临床进展的预测价值;采用χ^(2)检验分析血清PD-L1与ESCC患者临床病理特征之间的相关性,两独立样本Wilcoxon秩和检验比较血清PD-L1高值组与低值组T淋巴细胞亚群水平的差异。结果:ESCC组PD-L1水平显著高于对照组,且Ⅲ-Ⅳ期的ESCC患者血清PD-L1含量明显高于Ⅰ-Ⅱ期(P<0.05)。ESCC组CD4^(+)PD-1^(+)T细胞百分比显著高于对照组(P<0.05);而CD3^(+)T细胞绝对值计数、CD4^(+)T细胞绝对值计数、CD4^(+)CD28^(+)T细胞绝对值计数、CD8^(+)CD28^(+)T细胞百分比和绝对值计数明显低于对照组(P<0.05)。ESCC组Ⅲ-Ⅳ期CD4^(+)PD-1^(+)T细胞百分比明显高于Ⅰ-Ⅱ期;而CD4^(+)CD28^(+)T细胞百分比和绝对值计数明显低于Ⅰ-Ⅱ期(P<0.05)。血清PD-L1的含量与ESCC患者的临床进展密切相关,且具有较高预测价值(P<0.05)。PD-L1高值组CD4^(+)PD-1^(+)T细胞百分比明显高于低值组(P<0.05),而CD4^(+)CD28^(+)T细胞百分比和绝对值计数、CD8^(+)CD28^(+)T细胞百分比和绝对值计数明显低于低值组(P<0.05)。结论:ESCC患者血清PD-L1水平与T淋巴细胞表面抗原PD-1和CD28表达水平密切相关,这可能是其抑制T淋巴细胞免疫功能、促进ESCC细胞免疫逃逸的重要因素之一。

Objective:To investigate the correlation between serum programmed death-ligand 1(PD-L1)and T lymphocyte immune function in patients with esophageal squamous cell carcinoma(ESCC).Methods:62 patients with ESCC who were newly diagnosed in our hospital from August 2021 to January 2022 were enrolled as ESCC group,and 29 patients in the control group were from relatively healthy people.The two independent samples Wilcoxon rank sum test was uesd to compare the levels of serum PD-L1 and T lymphocyte subsets between the two groups and the differences of these indexes in different clinical stages in the ESCC group.The prediction value of the discrepant indexes in clinical stages on the clinical progress of ESCC was evaluated by the ROC curve.The correlation between serum PD-L1 level and clinical pathological features in ESCC patients was analyzed byχ^(2) test.Two independent samples Wilcoxon rank sum test was used to compare the levels of T lymphocyte subsets between the high and low PD-L1 groups.Results:The level of PD-L1 in ESCC group was significantly higher than that in control group,and the level of PD-L1 in ESCC patients in stageⅢ-Ⅳwas significantly higher than that in stageⅠ-Ⅱ(P<0.05).The percentage of CD4^(+)PD-1^(+)T cells in ESCC group was significantly higher than that in control group(P<0.05).CD3^(+)T cell absolute count,CD4^(+)T cell absolute count,CD4^(+)CD28^(+)T cell absolute count,CD8^(+)CD28^(+)T cell percentage and absolute count were significantly lower than those of control group(P<0.05).The percentage of CD4^(+)PD-1^(+)T cells in stageⅢ-Ⅳof ESCC group was significantly higher than that in stageⅠ-Ⅱ.The percentage and absolute value of CD4^(+)CD28^(+)T cells were significantly lower than those of stageⅠ-Ⅱ(P<0.05).The level of serum PD-L1 was closely related to the clinical progress of ESCC patients,and had a high predictive value(P<0.05).The percentage of CD4^(+)PD-1^(+)T cells in high PD-L1 group was significantly higher than that in low PD-L1 group(P<0.05),while the percentage and absolute count of CD4^(+)CD28^(+)T cells,percentage and absolute count of CD8^(+)CD28^(+)T cells were significantly lower than those of the low value group(P<0.05).Conclusion:Serum PD-L1 level is closely related to the levels of T lymphocyte surface antigens PD-1 and CD28,which may be one of the important factors in inhibiting T lymphocyte immune function and promoting immune escape of ESCC cells.