中国人群甲状腺髓样癌中 PD-1/PD-L1 的表达：临床病理和预后分析。

PD-1/PD-L1 expressions in medullary thyroid carcinoma: Clinicopathologic and prognostic analysis of Chinese population.

机构信息

Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.

出版信息

Eur J Surg Oncol. 2019 Mar;45(3):353-358. doi: 10.1016/j.ejso.2018.10.060. Epub 2018 Oct 21.

DOI:10.1016/j.ejso.2018.10.060

PMID:30528043

Abstract

INTRODUCTION

Few studies have focused on PD-L1 expression in medullary thyroid carcinoma (MTC). Expressions of PD-1 and PD-L1 and their clinicopathologic and prognostic relevance were therefore further investigated on a relatively large population of MTC patients.

MATERIALS AND METHODS

Surgical specimens were obtained from 87 MTC patients during a median follow-up of 37.7 months. PD-1 and PD-L1 expressions on tumor and associated immune cells were studied immunohistochemically using >1% positive cells as a threshold for positivity. Their correlations with clinicopathologic and prognostic feature were analyzed.

RESULTS

PD-1 and PD-L1 were positively stained in 22 and 19 MTC patients. Most PD-L1-positive cases (18/19) showed weak to moderate staining intensity. PD-1 and PD-L1 were co-expressed in 11 patients. PD-L1 positivity was significantly correlated with distant metastases at surgery (21.1% vs 1.5%, P = 0.007). Coexpression of PD-1 and PD-L1 in MTC was correlated with advanced pathologic TNM stage III/IV (P = 0.040) and distant metastases at surgery (P = 0.013). However, there was no other clinicopathologic and prognostic relevance regarding to PD-1, PD-L1 or their coexpression in our MTC patients.

CONCLUSION

PD-1/PD-L1 pathway was expressed in MTC patients and was significantly correlated with the distant metastases at surgery, which may shed light on PD-1/PD-L1 as a promising therapeutic target in MTC. Future better understanding of PD-1/PD-L1 expression and their relationship with immunotherapy response may provide direct evidence for management of refractory MTC.

摘要

简介

很少有研究关注髓样甲状腺癌（MTC）中 PD-L1 的表达。因此，本研究进一步在相对较大的 MTC 患者人群中研究了 PD-1 和 PD-L1 的表达及其与临床病理和预后的相关性。

材料与方法

在中位随访 37.7 个月期间，从 87 例 MTC 患者中获得手术标本。使用>1%的阳性细胞作为阳性阈值，通过免疫组织化学研究 PD-1 和 PD-L1 在肿瘤和相关免疫细胞上的表达。分析它们与临床病理和预后特征的相关性。

结果

22 例和 19 例 MTC 患者 PD-1 和 PD-L1 呈阳性染色。大多数 PD-L1 阳性病例（18/19）显示弱阳性至中度染色强度。11 例患者 PD-1 和 PD-L1 共表达。PD-L1 阳性与手术时的远处转移显著相关（21.1%比 1.5%，P=0.007）。MTC 中 PD-1 和 PD-L1 的共表达与晚期病理 TNM 分期 III/IV（P=0.040）和手术时的远处转移（P=0.013）相关。然而，在我们的 MTC 患者中，PD-1、PD-L1 或它们的共表达与其他临床病理和预后无关。