胃腺癌组织中PD-L1与HER-2的表达及临床意义

目的观察胃腺癌中PD-L1的表达,分析PD-L1与HER-2表达的相关性及对预后的影响。方法收集西安交通大学第一附属医院存档的75例胃腺癌标本,采用免疫组化MaxVision法及FISH技术检测PD-L1、HER-2的表达。结果75例胃腺癌中,PD-L1阳性43例,阳性率为57.3%,HER-2过表达13例,过表达率为17.3%。胃腺癌中PD-L1表达与分化程度呈负相关(r=-0.26,P<0.05);相关性分析显示,PD-L1表达与HER-2表达呈正相关(r=0.25,P=0.029)。生存分析中HER-2及PD-L1不同表达组中HER-2过表达PD-L1阳性组的5年生存率最低,且HER-2表达是影响胃腺癌患者生存期的独立预后因素。结论PD-L1相关治疗可成为胃腺癌治疗的新靶点。在胃腺癌中联合应用PD-L1与抗HER-2治疗可能成为胃腺癌治疗的新途径。

Correlation between expression of PD-L1 and HER-2 in gastric adenocarcinoma and its prognostic significance

Purpose To observe the expression of PD-L1 in gastric adenocarcinoma,to analyze the correlation between PD-L1 expression and HER-2 expression and its effect on prognosis.Methods A total of 75 patients with gastric adenocarcinoma in the First Affiliated Hospital of Xi’an Jiaotong University were collected,the expression of PD-L1,HER-2 and related clinicopathological factors were detected by immunohistochemistry and FISH.Results PD-L1 expression was positive in 43 cases,the positive rate was 57.3%.HER-2 over-expression was 13 cases,and the over-expression rate was 17.3%.PD-L1 expression was negatively correlated with gastric adenocarcinoma differentiation(r=-0.26,P<0.05).Spearman analysis showed that the expression of PD-L1 was positively correlated with the expression of HER-2.The survival analysis of different HER-2 and PD-L1 expression groups in HER-2 overexpression group and PD-L1 positive group had the lowest 5-year survival rate,and HER-2 expression was an independent prognostic factor affecting the survival of gastric adenocarcinoma.Conclusion PD-L1 related treatment can become a new target for the treatment of gastric adenocarcinoma the combined treatment of PD-L1 and anti-HER-2 in gastric adenocarcinoma may be a new approach for the treatment of gastric adenocarcinoma.