腹膜间皮瘤中TILs、PD-1和PD-L1的表达与预后的关系

Relationship between tumor-infiltrating lymphocytes,PD-1 and PD-L1 expression with the prognosis of peritoneal mesothelioma

目的探讨腹膜间皮瘤(peritoneal mesothelioma,PM)中CD3、CD4、CD8、CD20、CD68、PD-1和PD-L1的表达及与PM临床预后的关系。方法收集69例PM患者的临床病理资料,采用免疫组化EnVision两步法检测PM组织中CD3、CD4、CD8、CD20、CD68、PD-1和PD-L1的表达,Cox单因素和多因素比例风险回归模型分析蛋白表达水平与患者预后的关系。结果上皮样型和非上皮样型PM肿瘤浸润淋巴细胞(tumor infiltrating lymphocytes,TILs)中CD3、CD4、CD8、CD20、CD68、PD-1的表达均无明显差异。PD-L1在非上皮样型PM TILs中的表达高于上皮样型,但差异无统计学意义。PM患者的中位总生存期为19.1个月。Cox多因素分析显示石棉暴露(P=0.002)、PCI评分(P=0.034)、组织学类型(P=0.036)和CD4表达(P=0.043)是PM的独立预后因素。结论石棉暴露、PCI评分、组织学类型、TILs中CD4的表达对PM患者生存有显著影响。

Purpose To investigate the relationship between the expressions of CD3,CD4,CD8,CD20,CD68,PD-1 and PD-L1 and the clinical prognosis of peritoneal mesothelioma(PM).Methods Clinical data of 69 PM patients were collected.EnVision two-step immunohistochemical method was used to detect the expression of CD3,CD4,CD8,CD20,CD68,PD-1 and PD-L1 in PM.Associations between expression levels and survival were estimated by univariate and multivariate Cox proportional-hazards models.Results There were no significant differences in the expressions of CD3,CD4,CD8,CD20,CD68,and PD-1 in tumor infiltrating lymphocytes(TILs)of epithelioid and non-epithelioid PM.The expression of PD-L1 in non-epithelioid PM TILs was higher than that in epithelioid PM TILs,but the difference was not statistically significant.The median overall survival(mOS)time of PM was 19.1 months.Multivariate models identified asbestos exposure(P=0.002),PCI score(P=0.034),histological type(P=0.036),and CD4 expression(P=0.043)was independent prognostic factors for PM.Conclusion Asbestos exposure,PCI score,histological type and CD4 expression in TILs may exert significant impacts on survival of PM patients.