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程序性死亡配体1(PD-L1)在晚期非小细胞肺癌中的预后意义

Prognostic significance of PD-L1 in advanced non-small cell lung carcinoma.

作者信息

Zhao Yanjie, Shi Feng, Zhou Quan, Li Yuchen, Wu Jiangping, Wang Ruibin, Song Qingkun

机构信息

Department of Medical Oncology.

Department of Environmental Health Sciences, Arnold School of Public Health, University of South Carolina, Columbia, SC.

出版信息

Medicine (Baltimore). 2020 Nov 6;99(45):e23172. doi: 10.1097/MD.0000000000023172.

Abstract

This study aimed to investigate the prognostic value of PD-L1 in Chinese patients with non-small cell lung carcinoma (NSCLC).In this retrospective study, 97 patients with NSCLC were consecutively recruited. The expression profiling of PD-1, PD-L1, p53 and Ki-67 was detected by immunohistochemistry. Median survival time was estimated by Kaplan-Meier survival curve with log-rank test. Risk factors were evaluated by Cox Proportional Hazards regression models.The median tumor size was larger (3.5 cm) among patients with positive PD-L1 expression, compared to those with negative expression (2.0 cm; P < .01). Compared to those with negative PD-L1 expression, patients with positive PD-L1 expression had significantly higher rates of nerve invasion (26.3% vs 5.0%; P < .01), blood vessel invasion (47.4% vs 20.0%; P < .01) and lymph node metastasis (64.9% vs 27.5%; P < .01), more advanced tumor stage (P < .01) and Ki-67 index (P < .01). PD-L1 expression status was not significantly associated with disease-free (DFS) or overall survival (OS). However, for patients with advanced disease, PD-L1 positive expression was related to worse outcome (HR: 4.13; 95% CI: 1.06-16.12).Positive PD-L1 expression is associated with more aggressive pathological features and poorer prognosis in advanced stage NSCLC.

摘要

本研究旨在探讨程序性死亡配体1(PD-L1)在中国非小细胞肺癌(NSCLC)患者中的预后价值。在这项回顾性研究中,连续招募了97例NSCLC患者。采用免疫组织化学法检测PD-1、PD-L1、p53和Ki-67的表达谱。通过Kaplan-Meier生存曲线和对数秩检验估计中位生存时间。采用Cox比例风险回归模型评估危险因素。与PD-L1表达阴性的患者相比,PD-L1表达阳性的患者中位肿瘤大小更大(3.5厘米)(2.0厘米;P<0.01)。与PD-L1表达阴性的患者相比,PD-L1表达阳性的患者神经侵犯率(26.3%对5.0%;P<0.01)、血管侵犯率(47.4%对20.0%;P<0.01)和淋巴结转移率(64.9%对27.5%;P<0.01)显著更高,肿瘤分期更晚(P<0.01),Ki-67指数更高(P<0.01)。PD-L1表达状态与无病生存期(DFS)或总生存期(OS)无显著相关性。然而,对于晚期疾病患者,PD-L1阳性表达与更差的预后相关(风险比:4.13;95%置信区间:1.06 - 16.12)。PD-L1阳性表达与晚期NSCLC更具侵袭性的病理特征和更差的预后相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fec9/7647545/7721261553b0/medi-99-e23172-g001.jpg

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