PD-L1在浸润性肺腺癌各亚型中的表达及其与预后的关系

Expression of PD-L1 in Each of the Invasive Lung Adenocarcinoma Subtypes and Its Relationship with Prognosis

目的探讨程序性死亡分子-1配体(PD-L1)在浸润性肺腺癌(LUAD)各亚型中的表达及其与预后的关系。方法回顾性分析135例浸润性LUAD患者临床资料,采用免疫组化方法测定浸润性LUAD患者中PD-L1表达情况。分析PD-L1在浸润性LUAD各亚型中的表达情况,统计患者2年总生存率(OS),分析PD-L1与浸润性LUAD患者预后的关系。结果腺泡型、贴壁型、乳头型、微乳头型、实体型病理亚型的PD-L1阳性表达率比较,差异有统计学意义(P<0.05),其中实体型的浸润性LUAD患者中PD-L1阳性表达率最高。随访2年,135例浸润性LUAD患者中存活78例,2年OS为57.78%(78/135);PD-L1阳性患者生存率低于PD-L1阴性患者,差异有统计学意义(P<0.05);Logistic回归分析显示,PD-L1为影响浸润性LUAD患者预后的独立危险因素(P<0.05且OR≥1)。结论PD-L1在实体型浸润性LUAD中呈阳性表达,且PD-L1与患者预后间具有密切联系,PD-L1阳性表达是浸润性LUAD患者预后的不利因素,可为临床浸润性LUAD患者的治疗及预后评估提供指导。

Objective To investigate the expression of the programmed death molecule-1 ligand(PD-L1)in the relationship and prognosis of each subtype of invasive lung adenocarcinoma(LUAD).Methods The clinical data of 135 invasive LUAD patients were retrospective analyzed.PD-L1 expression was measured in invasive LUAD patients by immunohistochemistry.The expression of PD-L1 in the invasive LUAD subtypes and the prognosis of PD-L1 and invasive LUAD patients were analyzed,and the 2-year overall survival rate(OS)was counted.Results The positive PD-L1 expression rates of the acinar,adherent,papillary,micropapillary,and solid pathological subtypes had statistically significant difference(P<0.05);The rate of PD-L1 positive expression was highest in invasive LUAD patients with solid type;Follow-up for 2 years,135 Patients with invasive LUAD survived 78 at 2 years,The 2-year OS was 57.78%(78/135);The PD-L1-positive patients had lower survival rates than those in the PD-L1-negative patients,The difference was statistical significant(P<0.05);Logistic regression analysis showed that,PD-L1 was an independent risk factor(P<for invasive LUAD<0.05 and OR 1).Conclusion PD-L1 is positively expressed in solid invasive LUAD,and PD-L1 is closely related with prognosis,positive expression of PD-L1 is an unfavorable factor affecting the prognosis of invasive LUAD and helps to guide the treatment and prognostic evaluation of patients with clinically invasive LUAD.