PD-1和PD-L1在肺类癌中的表达情况和其临床意义

背景与目的肺类癌（pulmonary carcinoid, PC）是一种发病率极低的肺部原发性恶性肿瘤，临床预后与其病理特征密切相关。本研究旨在检测分析PC组织中PD-1（programmed death-1）和PD-L1（programmed death ligand-1）的表达情况及其与类癌患者临床病理生理特征的相关性。方法应用免疫组织化学法检测了20例PC石蜡包埋组织标本中PD-1和PD-L1的蛋白表达情况；应用Hscore（HS）评分系统（0-300）对肿瘤组织中PD-L1和PD-1的表达进行了分析评价。结果 PD-1和PD-L1在PC组织中的阳性表达率分别为40%（8/20）和45%（9/20）。其中，在吸烟PC患者中，PD-1的阳性表达率为63.64%，明显高于不吸烟的患者（11.11%, P<0.05）；PD-1与PD-L1的阳性表达与类癌患者的年龄、性别、病理类型、临床分期以及有无转移均无明显的相关性（P>0.05）。结论 PD-1和PD-L1的表达在40%左右的PC患者中呈阳性。其中，吸烟类癌患者肿瘤组织中PD-1的阳性表达率明显高于不吸烟患者。这些结果提示PD-1和PD-L1的阳性表达可能与PC的发生、发展存在一定的相关性。

Expression and Clinical Signiifcance of PD-1 and PD-L1 in Pulmonary Carcinoids

Background and objective The incidence of pulmonary carcinoid (PC) is very rare in primary lung malignant tumors, and the prognosis of this disease is closely associated with its pathological features. In this study, the expres-sions of programmed death 1 (PD-1) and programmed death ligand-1 (PD-L1) in lung carcinoid cells were detected, and the correlation between the expression and corresponding clinical physiological and pathologic features was further analyzed. Methods The expressions of PD-1 and PD-L1 in 20 cases of PC paraffn-embedded tissue specimens were detected through immunohistochemistry. hTe H-score of immunohis to chemical staining (range, 0-300) was employed to evaluate the expres-sion of PD-1 and PD-L1 in the tumor tissues.Results In the 20 cases of patients with PC, 40% (8/20) showed positive expres-sions of PD-1, and 45% (9/20) showed positive expressions of PD-L1. Signiifcantly higher expressions of PD-1 were observed in the smoking patients than in the nonsmoking patients (63.64%vs 11.11%,P<0.05). Furthermore, no signiifcant relationship was found between the expressions of PD-1 and PD-L1 and the clinical characteristics of the patients, such as age, gender, pathological type, clinical stage, and metastasis (P>0.05).Conclusion Approximately 40% of PC patients had positive expres-sions of PD-1or PD-L1. The positive expression rate of PD-1 in the smoking patients was signiifcantly higher than that in the nonsmoking patients. hTese results suggest that the expressions of PD-1 and PD-L1 may be associated with the occurrence and development of PC.(PD-L1)