文章摘要

PD-1在非小细胞肺癌组织中的表达及临床意义

作者: 1陈海婷, 1卞伟钢, 1沈阳, 1周小宁
1 盐城市第一人民医院肿瘤科,江苏 盐城 224000
通讯: 卞伟钢 Email: 3400923996@qq.com
DOI: 10.3978/j.issn.2095-6959.2020.12.003

摘要

目的:探讨程序性死亡因子1(programmed death 1,PD-1)在非小细胞肺癌组织中的表达水平及其临床意义。方法:回顾性分析2014年5月至2015年12月盐城市第一人民医院经手术切除且经病理组织学或细胞学检查确诊为非小细胞肺癌的组织标本86例及癌旁正常肺组织标本60例,采用免疫组织化学SP法检测其组织中PD-1的表达情况,分析其与临床病理特征的关系。对86例手术患者进行术后随访,随访时间为手术结束后5年,分析PD-1与患者预后的关系。结果:PD-1蛋白阳性表达主要定位于肿瘤间质内浸润的淋巴细胞膜及胞质,呈棕黄色颗粒。在86例非小细胞肺癌组织中,PD-1阳性表达率为65.12%。在60例癌旁正常肺组织中,PD-1阳性表达率为8.33%。与癌旁正常肺组织相比,非小细胞肺癌组织中的PD-1阳性细胞水平明显较高,差异有统计学意义(P<0.05)。PD-1表达与非小细胞肺癌患者的性别、年龄、肿瘤直径、浸润深度、分化程度无明显相关性,差异无统计学意义(P>0.05),而与患者的淋巴结转移情况及TNM分期密切相关,差异有统计学意义(P<0.05)。非小细胞肺癌PD-1阴性表达和PD-1阳性表达患者的中位生存时间分别为28.9个月和50.7个月,与非小细胞肺癌PD-1阳性表达患者相比,非小细胞肺癌PD-1阴性表达患者的生存时间明显较长,差异有统计学意义(P<0.05)。单因素分析结果显示:肿瘤生存期与患者的性别、年龄、肿瘤分化程度及浸润深度无关,与TNM分期及淋巴结转移情况密切相关,差异有统计学意义(P<0.05)。非小细胞肺癌患者生存时间多因素分析结果显示:TNM分期、淋巴结转移情况及PD-1阳性表达是非小细胞肺癌患者的重要影响因素,差异有统计学意义(P<0.05)。结论:非小细胞肺癌组织中的PD-1阳性细胞呈现高表达水平,PD-1的表达水平与临床病理特征之间存在一定的关联。PD-1有助于提示非小细胞肺癌的病情发展中的变化,有利于对患者预后以及转归的判断。
关键词: 程序性死亡因子1;非小细胞肺癌;预后

Expression and clinical significance of PD-1 in non-small cell lung cancer

Authors: 1CHEN Haiting, 1BIAN Weigang, 1SHEN Yang, 1ZHOU Xiaoning
1 Department of Oncology, Yancheng First People’s Hospital, Yancheng Jiangsu 224000, China

CorrespondingAuthor: BIAN Weigang Email: 3400923996@qq.com

Abstract

Objective: To investigate the expression level of programmed death factor 1 (PD-1) in non-small cell lung cancer and its clinical significance. Methods: A retrospective analysis of 86 tissue specimens of non-small cell lung cancer and 60 adjacent normal lung tissue specimens from May 2014 to December 2015 in our hospital after resection and histopathological or cytological examinations, using the immune group The SP method was used to detect the expression of PD-1 in the tissues and analyze its relationship with clinicopathological characteristics. A total of 86 patients were followed up after surgery for 5 years to analyze the relationship between PD-1 and prognosis. Results: the positive expression of PD-1 protein was mainly located in the infiltrating lymphocyte membrane and cytoplasm in the tumor stroma, showing brownish yellow granules. In 86 cases of non-small cell lung cancer, the positive expression rate of PD-1 was 65.12%. PD-1 positive expression rate was 8.33% in 60 cases of adjacent normal lung tissues. Compared with adjacent normal lung tissues, the level of PD-1 positive cells in non-small cell lung cancer was significantly higher, with statistically significant difference (P<0.05). There was no significant correlation between PD-1 expression and gender, age, tumor diameter, invasion depth and differentiation degree of non-small cell lung cancer (P>0.05), but there was a close correlation between PD-1 expression and lymph node metastasis and TNM stage (P<0.05). The median survival time of patients with PD-1 negative expression and PD-1 positive expression was 28.9 months and 50.7 months, respectively. Compared with patients with PD-1 positive expression of non-small cell lung cancer, the survival time of patients with PD-1 negative expression of non-small cell lung cancer was significantly longer and the difference was statistically significant (P<0.05). Univariate analysis showed that tumor survival was not related to gender, age, tumor differentiation and invasion depth, but was closely related to TNM stage and lymph node metastasis (P<0.05). The results of multivariate analysis of survival time of non-small cell lung cancer patients showed that TNM stage, lymph node metastasis and PD-1 positive expression were important influencing factors of non-small cell lung cancer patients, with statistically significant differences (P<0.05). Conclusion: PD-1 positive cells in non-small cell lung cancer present high expression level, and there is a certain correlation between the expression level of PD-1 and the clinicopathological characteristics, which helps to indicate the changes in the disease development of non-small cell lung cancer, and is conducive to the judgment of prognosis and prognosis of patients.
Keywords: programmed death 1; non-small cell lung cancer; prognosis