Meng Yi, Wu Hongyan, Yao Yongzhong, Li Rong
Department of Oncology, The Affiliated Taikai Xianlin Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China.
Department of Pathology, the Affiliated Nanjing Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China.
Gland Surg. 2020 Dec;9(6):2106-2115. doi: 10.21037/gs-20-824.
The purpose of this study is to investigate the association between protein expression of programmed death-ligand 1 (PD-L1) and the clinicopathological features of patients with invasive breast cancer.
Clinicopathological data of 651 patients with invasive breast carcinoma were collected over a 1-year period. Patients whose breast tissue samples did not express genes for the estrogen receptor (ER), progesterone receptor (PR), or human epidermal growth factor receptor-2 (HER2) were classified as triple-negative breast cancer (TNBC). The correlations of PD-L1 expression with clinicopathological features and overall survival were determined using Pearson's correlation coefficient and logistic binary regression analysis, respectively.
Positive expression of PD-L1 was detected in 47% of patients with invasive breast carcinoma, compared with 69.3% of TNBC patients (P<0.05). Furthermore, expression of PD-L1 in patients with invasive breast carcinoma was significantly correlated with WHO grade, tumor size, vascular invasion, pathological stage, and the expression of ER, PR, nuclear associated antigen Ki67 (Ki67), gene, cytokeratin 5/6 (CK5/6), and epidermal growth factor receptor (EGFR) (P<0.05). Logistic binary regression analysis showed that WHO grade, Ki67, p53, and EGFR were independent risk factors for the expression of PD-L1 in patients with invasive breast cancer. Moreover, PD-L1 expression in TNBC patients was significantly correlated with WHO grade, neuro-invasion, Ki67, CK5/6, and EGFR (P<0.05), but it was not correlated with age, tumor size, vascular invasion, number of lymph nodes, pathological stage, or the expression of ER, PR, p53, androgen receptor (AR), or vascular endothelial growth factor receptor (VEGFR) (P>0.05).
The high expression rate of PD-L1 in invasive breast cancer is closely related to some clinicopathological features. Thus, immunotherapy with PD-L1 inhibitors could be a potential treatment strategy for patients with invasive breast cancer.
本研究旨在探讨程序性死亡配体1（PD-L1）蛋白表达与浸润性乳腺癌患者临床病理特征之间的关联。
在1年的时间里收集了651例浸润性乳腺癌患者的临床病理数据。乳腺组织样本未表达雌激素受体（ER）、孕激素受体（PR）或人表皮生长因子受体2（HER2）基因的患者被归类为三阴性乳腺癌（TNBC）。分别采用Pearson相关系数和逻辑二元回归分析确定PD-L1表达与临床病理特征及总生存期的相关性。
47%的浸润性乳腺癌患者检测到PD-L1阳性表达，而TNBC患者中这一比例为69.3%（P<0.05）。此外，浸润性乳腺癌患者中PD-L1的表达与世界卫生组织（WHO）分级、肿瘤大小、血管侵犯、病理分期以及ER、PR、核相关抗原Ki67（Ki67）、基因、细胞角蛋白5/6（CK5/6）和表皮生长因子受体（EGFR）的表达显著相关（P<0.05）。逻辑二元回归分析显示，WHO分级、Ki67、p53和EGFR是浸润性乳腺癌患者PD-L1表达的独立危险因素。此外，TNBC患者中PD-L1的表达与WHO分级、神经侵犯、Ki67、CK5/6和EGFR显著相关（P<0.05），但与年龄、肿瘤大小、血管侵犯、淋巴结数量、病理分期或ER、PR、p53、雄激素受体（AR）或血管内皮生长因子受体（VEGFR）的表达无关（P>0.05）。
浸润性乳腺癌中PD-L1的高表达率与一些临床病理特征密切相关。因此，使用PD-L1抑制剂进行免疫治疗可能是浸润性乳腺癌患者的一种潜在治疗策略。
