PD-L1及微血管密度在肉瘤样肾细胞癌中的表达及意义

Expression and significance of PD-L1 and microvessel density in sarcomatoid renal cell carcinoma

目的探讨肉瘤样肾细胞癌组织中PD-L1的表达及肿瘤内微血管密度情况,为肉瘤样肾细胞癌免疫治疗及靶向治疗方案的选择提供理论依据。方法通过免疫组化法检测PD-L1、CD31及CD34在16例肉瘤样肾细胞癌(癌成分均为透明细胞肾细胞癌)中的表达,并评估肿瘤微血管密度。结果16例肿瘤中CD31和CD34免疫组化染色显示,肉瘤样肾细胞癌区域微血管密度明显高于不伴肉瘤样分化的区域,微血管密度计数分别为68.6±25.8 vs 38.7±16.0(t=3.931,P=0.0005)和69.5±28.1 vs 40.1±18.4(t=3.506,P=0.0015),差异有统计学意义。肉瘤样区域PD-L1表达水平高于非肉瘤样区域,CPS分别为34.7±26.9和25.9±27.6,但差异无统计学意义。结论在肉瘤样肾细胞癌中,肉瘤样区域微血管密度和PD-L1表达水平明显高于非肉瘤样区域,提示靶向治疗联合免疫治疗可能为此类肿瘤提供一种有效的治疗方法。

Purpose To explore the expression of PD-L1 and microvessel density in sarcomatoid renal cell carcinoma,and to provide a theoretical basis for the selection of immunotherapy and targeted therapy.Methods The expression of PD-L1,CD31 and CD34 in sarcomatoid renal cell carcinoma was detected by immunohistochemistry method,and the tumor microvessel density was assessed.Results Immunohistochemical staining for CD31 and CD34 in 16 tumor tissues showed that the microvessel density was significantly higher in sarcomatoid renal cell carcinoma areas than in areas without sarcomatoid differentiation,and the microvascular density was 68.6±25.8 vs 38.7±16.0 and 69.5±28.1 vs 40.1±18.4,respectively.The difference was statistically significant(t=3.931 and t=3.506,P=0.0005 and P=0.0015).The expression of PD-L1 was higher in sarcomatoid areas than that in non-sarcomatoid areas.The CPS was 34.7±26.9 and 25.9±27.6,respectively,but the difference was not statistically significant.Conclusion In sarcomatoid renal cell carcinoma,the microvascular density and the expression of PD-L1 in sarcomatoid areas are significantly higher than those in non-sarcomatoid areas,suggesting that the combination of targeted therapy and immunotherapy may be an effective treatment for this type of tumor.