肺腺癌患者中PD-L1与Ki-67表达的相关性及其对预后的影响

Correlation between PD-L1 and Ki-67 expression in lung adenocarcinoma and its effect on prognosis

目的检测肺腺癌病理组织中程序性死亡配体1(PD-L1)、细胞增殖核抗原(Ki-67)的表达水平,分析PD-L1、Ki-67间的相关性及其对预后的影响。方法收集2017年1月至2022年5月生产建设兵团第一师医院病理科确诊的146例肺腺癌患者,采用免疫组化法分别检测PD-L1和Ki-67的表达水平,通过Pearson相关分析其相关性,单因素生存分析其在肺腺癌中的预后。结果肺腺癌病理组织中PD-L1蛋白表达阳性率达38.36%(56/146),其表达与患者的性别、族别、是否吸烟、组织学类型、淋巴结转移、分化、组织来源等均无关(P>0.05);Ki-67表达≥14%和≥50%的阳性率分别为80.82%(118/146)、30.82%(45/146),其表达与TNM分期、淋巴结转移有关(P<0.05)。经Pearson相关分析结果显示,Ki-67≥14%与PD-L1表达成正相关(r=0.205,P=0.013),Ki-67≥50%与PD-L1表达无相关性(r=0.023,P=0.787)。PD-L1阳性患者的中位生存期为18.5个月,明显短于PD-L1阴性患者的21.9个月,差异具有统计学意义(P<0.05);Ki-67表达≥14%的患者中位生存时间与Ki-67表达<14%的患者分别为20.7个月、20.3个月,差异无统计学意义(P>0.05),而Ki67表达≥50%的患者的中位生存时间为18.6个月,明显短于Ki-67表达<50%患者的21.4个月,差异有统计学意义(P<0.05)。结论肺腺癌中PD-L1与Ki-67≥14%的表达成正相关,Ki-6750%阈值点联合PD-L1的表达可能对肺腺癌患者的预后具有一定的临床指导意义。

Objective To analyze the correlation between PD-L1 and Ki-67 and their effects on prognosis by detecting the expression levels of programmed death ligand 1(PD-L1)and proliferative associated antigen(Ki-67)in pathological tissues of lung adenocarcinoma.Methods A total of 146 patients who were diagnosed as lung adenocarcinoma from January 2017 to May 2022 at the Department of Pathology,the First Division Hospital of Xinjiang Production and Construction Corps were collected retrospectively.The expression of PD-L1 and Ki-67 were detected by immunohistochemistry,and their correlation was analyzed through Pearson correlation.The prognosis of PD-L1 and Ki-67 in lung adenocarcinoma was analyzed through univariate survival analysis.Results The positive expression rate of PD-L1 protein was 38.36%(56/146),which was not related to the patient's sex,ethnicity,smoking,histological type,lymph node metastasis,differentiation,and tissue origin(P>0.05).The positive rates of Ki-67 expression≥14% and≥50%were 80.82%(118/146)and 30.82%(45/146),respectively,which were related to TNM stage and lymph node metas tasis(P<0.05).According to Pearson correlation analysis,Ki-67≥14%was positively correlated with PD-L1 expression(r=0.205,P=0.013),while Ki-67≥50% was not correlated with PD-L1 expression(r=0.023,P=0.787).The median survival time of PD-L1 positive patients was 18.5 months,significantly shorter than 21.9 months of PD-L1 negative patients(P<0.05).The median survival time of patients with Ki-67 expression≥14% and Ki-67 expression<14% was 20.7 months and 20.3 months,respectively,with no statistically significant difference(P>0.05).The median survival time of patients with Ki-67 expression≥50% was 18.6 months,significantly shorter than 21.4 months of patients with Ki-67 expression<50%(P<0.05).Conclusion There is a positive correlation between PD-L1 and Ki-67≥14% expression in lung adenocarcinoma.The combination of 50% threshold point of Ki-67 and PD-L1 expression may have certain clinical guiding significance for the prognosis of lung adenocarcinoma patients.