Department of Breast Surgery, Beijing Shijitan Hospital, Capital Medical University, Tieyi Road 10, Haidian District, Beijing, 100038, China.
Department of Cancer Research, Beijing Shijitan Hospital, Capital Medical University, Tieyi Road 10, Haidian District, Beijing, 100038, China.
Diagn Pathol. 2022 Sep 10;17(1):68. doi: 10.1186/s13000-022-01249-w.
The expression of PD-L1 in the immune microenvironment can guide the application of immunosuppressants. In order to monitor the immune status of the body, repeated biopsies have to be taken. Our research aims to find new and convenient means to evaluate this indicator.
Eighty-three cases of newly diagnosed operable breast cancer without receiving preoperative treatment, were recruited from Beijing Shijitan Hospital between November 2018 and November 2019. The expression of PD-1/PD-L1 on circulating T lymphocytes was detected by flow cytometry and the expression of PD-L1 on immune cells in tumor microenvironment was detected by immunohistochemistry.
The median percentage of positive PD-1 and PD-L1 expression on circulating T lymphocytes was 15.2% and 0.7%, respectively. The peripheral PD-1 had no relationship with clinicopathological characteristics, but the peripheral PD-L1 expression had a correlation with lymph node metastasis (p = 0.005) and Her-2 expression (p = 0.034) (p < 0.05). The positive rate of PD-L1 expression was 32.9% in tumor microenvironment. PD-L1 expression in tumor microenvironment had a significant correlation with PD-1/PD-L1 expression on circulating T lymphocytes, the correlation coefficients being 0.24 (p < 0.05) and 0.26 (p < 0.05), respectively. To predict the PD-L1 expression in tumor microenvironment, the area under the receiver operating characteristic curve was 0.65 and 0.66 for peripheral PD-1 and PD-L1, respectively. High level of peripheral PD-1/PD-L1 expression was associated with the odds ratios of 5.42 and 4.76 for positive PD-L1 expression in tumor microenvironment.
Peripheral PD-1/PD-L1 expression had a significant consistency with PD-L1 expression in tumor microenvironment and could act as an alternative choice of tissue detection, for the patients intolerable of biopsy.
PD-L1 在免疫微环境中的表达可以指导免疫抑制剂的应用。为了监测机体的免疫状态，需要反复进行活检。我们的研究旨在寻找新的、方便的方法来评估这一指标。
本研究纳入 2018 年 11 月至 2019 年 11 月在北京世纪坛医院新诊断的 83 例未经术前治疗的可手术乳腺癌患者。采用流式细胞术检测循环 T 淋巴细胞上 PD-1/PD-L1 的表达，免疫组织化学法检测肿瘤微环境中 PD-L1 的表达。
循环 T 淋巴细胞上 PD-1 和 PD-L1 阳性表达的中位数分别为 15.2%和 0.7%。外周 PD-1 与临床病理特征无相关性，而外周 PD-L1 的表达与淋巴结转移（p=0.005）和 Her-2 表达（p=0.034）相关（p<0.05）。肿瘤微环境中 PD-L1 表达的阳性率为 32.9%。肿瘤微环境中 PD-L1 的表达与循环 T 淋巴细胞上 PD-1/PD-L1 的表达呈显著相关，相关系数分别为 0.24（p<0.05）和 0.26（p<0.05）。预测肿瘤微环境中 PD-L1 的表达，外周 PD-1 和 PD-L1 的受试者工作特征曲线下面积分别为 0.65 和 0.66。外周 PD-1/PD-L1 高表达与肿瘤微环境中 PD-L1 阳性表达的比值比分别为 5.42 和 4.76。
外周 PD-1/PD-L1 表达与肿瘤微环境中 PD-L1 表达具有显著一致性，可作为组织检测的替代选择，适用于不耐受活检的患者。
