程序性死亡受体-配体1(PD-L1)表达与可切除胰腺癌患者预后的关系

 目的  探讨行胰腺导管腺癌根治术的患者中程序性死亡受体-配体1(programmed cell death-ligand 1, PD-L1)表达情况与胰腺癌根治术患者预后的关系。方法  分析复旦大学附属中山医院普外科2015年7月至2017年8月68例行胰腺癌根治术患者的临床病理资料。根据病理结果将患者分为PD-L1表达阳性组和PD-L1表达阴性组。应用Kaplan-Meier法、Log-rank检验及Cox比例风险模型分析PD-L1表达与患者生存时间的关系。结果  68例患者平均年龄为62岁,PD-L1阳性51人,阴性17人。Kaplan-Meier法生存分析显示PD-L1阳性组患者的预后明显好于阴性组(P＜0.05),肿瘤大小和淋巴结转移情况与术后生存时间相关。对PD-L1阳性、肿瘤大小和淋巴结转移情况进行Cox比例风险模型多因素回归分析,PD-L1阳性、肿瘤大小和淋巴结转移情况均为胰腺癌患者术后生存时间的独立影响因素。结论  PD-L1表达与胰腺导管腺癌患者术后生存时间关系密切,可作为判断预后的辅助指标。

Prognostic analysis of PD-L1 expression in patients with resectable pancreatic adenocarcinoma

Objective  To investigate the relationship between the expression of programmed cell death-ligand 1 (PD-L1) and the prognosis of patients undergoing radical resection of pancreatic cancer. Methods  We analyzed the clinical and pathological data of 68 patients undergoing radical resection of pancreatic cancer from Jul., 2015 to Aug., 2017 in Department of General Surgery, Zhongshan Hospital, Fudan University. According to the pathological results, the patients were divided into PD-L1 positive expression group and PD-L1 negative expression group. Kaplan-Meier method, Log-rank test and Cox proportional hazard model were used to analyze the relationship between PD-L1 expression and survival time of patients. Results  The average age of 68 patients was 62 years old. PD-L1 expression was positive in 51 cases and negative in 17 cases. Kaplan-Meier survival analysis showed that the prognosis of  PD-L1 positive group was significantly better than that of the negative group (P<0.05). Moreover, tumor size and lymph node metastasis were associated with postoperative survival. PD-L1 positive expression, tumor size and lymph node metastasis were analyzed by Cox proportional hazard model multivariate analysis. We found that PD-L1 positive expression, tumor size and lymph node metastasis were independent factors influencing postoperative survival time of patients with pancreatic cancer. Conclusions  PD-L1 expression is closely related to the survival time of patients with pancreatic ductal adenocarcinoma and may be used as an auxiliary index to judge the prognosis.