PD-L1 在胃癌患者手术前后外周血T 细胞和单核细胞上的表达及意义

目的:检测胃癌患者术前术后外周血细胞表面PD-L1的表达,探讨其表达改变及临床意义。方法:收集44例胃癌患者术前术后和18名健康志愿者外周血标本,流式细胞术检测CD3⁺ CD4⁺ T、CD3⁺ CD8⁺ T 细胞表面PD-1 和PD-L1 以及CD14⁺单核细胞表面PD-L1 的表达。结果:与健康志愿者相比,胃癌患者外周血CD4⁺ T 和CD8⁺ T 细胞表面PD-L1 表达无显著差异(11.1±6.4)% vs (9.8±5.6)%,P =0.453 2;(13.9±12.0)% vs (12.0±7.1)%,P =0.558 9],而CD14⁺ 单核细胞表面PD-L1 表达水平显著增加(29.2±16.7)% vs (17.5±9.7)%,P=0.007 3]。但胃癌患者术后CD4+ T 细胞和CD8⁺ T 细胞表面PD-L1 的表达均显著高于术前水平(15.8±8.2)% vs (11.1±6.4)%,P= 0.001 5;(22.5±13.3)% vs (13.9±12.0)%,P =0.000 2],而术后外周血CD14+单核细胞PD-L1 表达水平并无显著变化(33.8±17.3)% vs (29.2±16.7)%,P=0.082 8]。同时,胃癌患者手术前后外周血CD4⁺T 和CD8⁺T 细胞表面PD-1的表达无统计学差异(25.6±9.9)% vs (26.9±8.9)%,P=0.505 5;(26.5±14.6)% vs (29.9±10.4)%,P=0.118 7]。结论:PD-L1 可作为监测原发性胃癌患者的免疫功能和预后评估的有效指标。

Expression of PD-L1 in peripheral blood T cells and monocytes of patients with gastric cancer before and after surgery and its clinical significance

Objective:To investigate the expression of PD-L1 in peripheral blood with gastric cancer patients and its clinical significance.Methods:Peripheral blood samples were collected from 44 gastric cancer patients (before and after the surgery) and 18 healthy subjects.The expression of PD-1 and PD-L1 on CD3⁺ CD4⁺ T,CD3⁺ CD8⁺ T cells and CD14⁺ monocytes was detected by flow cytometry.Results:The expression of PD-L1 on CD14⁺ monocytes of the gastric cancer patients was significantly higher than that of the healthy control(29.2±16.7)% vs (17.5±9.7)%,P=0.007 3],while there was no statistical difference on CD4⁺ T cells and CD8⁺ T cells(11.1±6.4)% vs (9.8±5.6)%,P=0.453 2;(13.9±12.0)% vs(12.0±7.1)%,P=0.558 9].The expression of PD-L1 on CD4⁺ T cells and CD8⁺ T cells in patients with gastric cancer was significantly higher than that before surgery(15.8±8.2)% vs (11.1±6.4)%,P=0.001 5;(22.5±13.3)% vs (13.9±12.0)%,P=0.000 2].However,no significant change was found on CD14+mononuclear cells(33.8±17.3)% vs (29.2±16.7)%,P=0.082 8].There was no significant difference in the expression of PD-1 on CD4⁺ T and CD8⁺ T cells before and after surgery(25.6±9.9)% vs (26.9±8.9)%,P=0.505 5;(26.5±14.6)% vs (29.9±10.4)%,P=0.118 7].Conclusion:PD-L1 can be used as an effective marker to monitor the immune function and prognosis of patients with primary gastric cancer.