结肠癌中PD-L1的表达及其与临床病理和预后的关系

目的:探讨程序性死亡因子配体1（PD-L1）的表达与结肠癌临床病理及预后的关系。方法:收集术前未予化疗治疗的临床病例资料齐全的原发性结肠癌病例80例，分别取其癌组织、癌旁组织、正常组织，采用免疫组化法检测PD-L1的表达。比较PD-L1表达与年龄、肿瘤大小、TNM分期、组织学分级、淋巴结转移、远处转移之间的关系，并结合随访资料分析PD-L1表达与否和预后的关系。结果:80例癌组织标本中，22例（27.5%）高表达PD-L1，24例（30.0%）中度表达PD-L1，34例（42.5%）弱表达或无PD-L1染色。癌旁和正常组织中PD-L1阳性表达率分别为9例(11.3%)和5例(6.3%)。PD-L1的表达与TNM分期（P=0.009）、淋巴结转移（P=0.000）、远处转移（P=0.014）呈正相关。PD-L1在年龄、性别、组织学分级和肿瘤大小中表达差异无统计学意义（P＞0.05）。Cox多变量分析显示:TNM 分期晚、分化程度低、淋巴结或远处转移、PD-L1 表达阳性是影响预后的独立危险因素。结论:PD-L1在结肠癌组织中表达明显升高，并与淋巴结转移及预后生存密切相关。

PD-L1 expression in colon cancer and its relationship with clinical pathology and prognosis

Objective:To explore the relationship between the expression of PD-L1 and the clinicopathology and prognosis of colon cancer.Methods:This study collected cases of primary colon cancer that had not undergone preoperative chemotherapy and had complete clinical data.Eighty specimens each were obtained from cancer tissues,paracancer tissues,and normal tissues.Immunohistochemical assays were performed to detect PD-L1 expression.The relationship between PD-L1 expression and clinicopathologic features was compared.This was combined with follow-up data,to analyze the relationship between positive or negative PD-L1 expression and prognosis.Results:Among the 80 tumor specimens,22 cases（27.5%） showed high PD-L1 expression,24 cases（30.0%） showed moderate PD-L1 expression,and 34 cases（42.5%） showed weak or no PD-L1 staining.The high expression of PD-L1 in paracancer and normal tissues were 9（11.3%) and 5（6.3%) cases,respectively.PD-L1 expression was also positively correlated with TNM stage（P=0.009）,lymph node metastasis（P=0.000）,distant metastasis（P=0.014）.There were no significant differences in different age,gender,histologic grade and tumor size groups（P＞0.05）.Multivariate analysis indicated that late TNM stage,poor tumor differentiation,lymph node metastasis,distant metastasis and positive PD-L1 expression were independent risk factors that influenced prognosis.Conclusion:PD-L1 expression was significantly elevated in colon cancer tissues,and was closely associated with lymph node metastasis,prognosis,and survival.