PD-L1在非小细胞肺癌中表达的临床意义

目的： 探讨程序性死亡配体-1(programmed death ligand-1，PD-L1)在非小细胞肺癌中的表达及其与临床病理特征和预后的关系。方法： 采用免疫组织化学SP法检测254 例肺腺癌、228 例肺鳞状细胞癌和99 例非癌对照肺组织中PD-L1 的表达，分析其表达与患者临床病理特征的关系；采用Kaplan-Meier 单因素法和Cox 多因素回归分析分别对肺腺癌、肺鳞状细胞癌患者的生存预后进行分析。结果： 肺腺癌、肺鳞状细胞癌中PD-L1 的阳性表达高于非癌对照肺组织(均P<0.05)，肺鳞状细胞癌中PD-L1 的阳性表达高于肺腺癌(P<0.05)；PD-L1 的阳性表达与肺腺癌、肺鳞状细胞癌患者的年龄、性别、病理学分级、临床分期、有无淋巴结转移均无关(均P>0.05)。PD-L1 阳性的肺腺癌患者总体生存率显著低于PD-L1 阴性的肺腺癌患者(P<0.01)。Cox多因素回归分析发现PD-L1 阳性的肺腺癌患者预后差(P<0.01)。结论： 肺鳞状细胞癌PD-L1 阳性表达高于肺腺癌；PD-L1 阳性表达可作为外科手术切除肺腺癌患者预后差的独立分子标志物。

Clinical significance of PD-L1 expression in patients with surgically resected non-small cell lung cancer

Objective: To explore the expression of programmed death ligand-1 (PD-L1) as well as thecorrelation between the expression and the clinicopathological features or prognosis in nonsmallcell lung cancer (NSCLC).Methods: The expression of PD-L1 protein in 254 cases of surgically resected lungadenocarcinoma (L-ADC)，228 cases of surgically resected lung squamous cell cancer (LSCC),and 99 cases of non-cancerous control lung tissues was detected withimmunohistochemical SP method. The correlation between the PD-L1 expression andclinicopathological features was analyzed. Kaplan-Meier univariate and Cox multivariateregression analyses were performed to assess the prognosis of patients with L-ADC and LSCC,respectively.Results: Positive percentage of PD-L1 protein expression was higher in the tissues of LADCand L-SCC than that in the non-cancerous control lung tissues respectively (both P<0.05). Positive percentage of PD-L1 protein expression was higher in the tissues of L-SCCthan that in the tissues of L-ADC (P<0.05). However, there were no correlation betweenthe expression of PD-L1 and age, gender, pathological grades, clinical stages, and lymphnode metastasis in L-ADC and L-SCC respectively (all P>0.05). Overall survival rate wasevidently lower in the L-ADC patients with positive expression of PD-L1 protein comparedto the patients with negative staining of PD-L1 (P<0.01). Multivariate Cox regressionanalysis further identified that the L-ADC patients of positive expression of PD-L1 proteinhad a poor prognosis (P<0.01).Conclusion: The positive percentage of PD-L1 protein expression is higher in the L-SCCpatients than that in the L-ADC patients. Positive expression of PD-L1 protein can beserved as an independent prognostic factor of poor prognosis in the patients with L-ADC.