肝癌患者 TACE 治疗前后外周血 PD-1、PD-L1 的 表达及临床意义

Expression and clinical significance of PD-1/PD-L1 in hepatocellular carcinoma patients

摘要:

目的??探讨原发性肝癌患者行肝动脉化疗栓塞术（TACE）前后外周血程序性死亡分子 1（PD-1） 、 配体（PD-L1）的表达及临床意义。方法??采集中南大学湘雅医学院附属海口医院 28 例中晚期肝癌患者（肝 癌组）TACE 治疗前后外周血及 20 例健康体检者（对照组）外周血标本， 流式细胞仪检测 CD4 + T、 CD8 + T 细胞及抗原提呈细胞（APC）表面 PD-1、 PD-L1 的表达， 并随访 PD-1、 PD-L1 表达与肿瘤分化、 疗效的关系。结果??肝癌组外周血CD4+ T、 CD8 + T细胞及APC表面PD-1、 PD-L1表达与对照组比较， 差异有统计学意义 （ P <0.05） ，肝癌组均高于对照组 ； 治疗前后肝癌组外周血 CD4 + T、CD8 + T 及 APC 表面 PD-L1 表达，差异有统计学意义（ P <0.05） ，治疗后较治疗前下降 ； CD4 + T、CD8 + T 及 APC 表面 PD-1 表达也较治疗前下降，但差异无统计学意义（ P >0.05） ； 细胞分化差的肝癌组患者外周血 PD-1、PD-L1 表达较高 ； 治疗效果差的肝癌组外周血PD-1、PD-L1 表达较高。结论??肝癌患者外周血 PD-1、PD-L1 表达升高，治疗前后监测 PD-1、PD-L1 表达可能预测患者预后状态。

Abstract:

Objective To investigate the expression of programmed death 1 (PD-1) / programmed death ligand 1 (PD-L1) in peripheral blood of patients with primary hepatocellular carcinoma (HCC) pre and post-transcatheter arterial chemoembolization (TACE) and its clinical significance. Methods A total of 20 healthy volunteers and 28 HCC patients were enrolled. The levels of PD-1 and PD-L1 on the surface of CD4 + T cells, CD8 + T cells and antigen- presenting cells (APC) in peripheral blood were detected by flow cytometry. Relationship between the expression of PD-1 and PD-L1 and the differentiation and outcomes of tumor was analyzed. Results The levels of PD-1 and PD-L1 on the surface of CD4 + T cells, CD8 + T cells and APC in peripheral blood of HCC patients were increased than those in healthy volunteers (P < 0.05). The expression of PD-L1 on the surface of CD4 + T cells, CD8 + T cells and APC in peripheral blood of HCC patients was decreased after TACE comparing to those in patients prior to treatments, while no obvious difference was identified in patients prior to and post treatments. High expression of PD-1 and PD-L1 was determined in patients with poor differentiation or poor outcomes. Conclusions The levels of PD-1 and PD-L1 in peripheral blood of patients with hepatocellular carcinoma are responsive to TACE and clinical prognosis.