PD-L1、Ki67 与非小细胞肺癌患者 临床病理特征及预后的关系

Relationship between PD-L1 and Ki67 and Clinicopathological Features and Prognosis in patients with Non-small Cell Lung Cancer

摘要:

目的 探讨PD-L1 和细胞核相关抗原Ki67 与非小细胞肺癌（NSCLC）患者临床病理特征及预 后的关系。方法 选取2017 年11 月—2018 年11 月浙江省立同德医院收治的90 例NSCLC 患者。HE 染色 观察肺组织病变，免疫组织化学法检测肺癌组织中PD-L1、Ki67 的表达。采用单因素分析和多因素Logistic 回归分析NSCLC 患者PD-L1、Ki67 表达与临床病理特征的关系，生存曲线分析NSCLC 患者PD-L1、Ki67 表达与预后的关系。结果 PD-L1 阳性患者62 例（68.89%），阴性患者28 例（31.11%）。Ki67 阳性患者58 例 （64.44%），阴性患者32 例（35.56%）。鳞癌、低分化、淋巴结转移患者PD-L1 阳性率较高（P <0.05）。女性、 鳞癌、低分化患者Ki67 阳性率较高（P <0.05）。Logistic 回归分析显示，病理分型、肿瘤分化程度、淋巴结转 移是PD-L1 高表达的影响因素（P <0.05）；性别、病理分型、肿瘤分化程度是Ki67 高表达的影响因素（P <0.05）。 PD-L1 阳性患者2 年生存率（48.39%）低于PD-L1 阴性患者（78.57%）（P <0.05），PD-L1 阳性患者的中位 生存时间为42 周，低于PD-L1 阴性患者的65 周（P <0.05）。Ki67 阳性患者2 年生存率（48.27%）低于Ki67 阴性患者（75.00%）（P <0.05），Ki67 阳性患者的中位生存时间为41 周，低于Ki67 阴性患者的66 周（P <0.05）。 结论 NSCLC 患者肺癌组织中存在PD-L1 和Ki67 高表达。NSCLC 患者的病理分型、肿瘤分化程度、淋巴 结转移与PD-L1 高表达有关；NSCLC 患者的性别、病理分型、肿瘤分化程度与Ki67 高表达有关。PD-L1、 Ki67 阳性患者预后较差。

Abstract:

Objective To investigate the relationship between programmed cell death ligand 1 (PD-L1) and nuclear antigen Ki67 (Ki67) and clinicopathological features and prognosis of patients with non-small cell lung cancer (NSCLC). Methods The clinical data of 90 NSCLC patients admitted to Tongde Hospital of Zhejiang Province from November 2017 to November 2018 were analyzed. HE staining was carried out to observe the pulmonary pathological changes, and the expression of PD-L1 and Ki67 in the pathological tissues of patients was detected by immunohistochemistry. Univariate analysis and multivariate logistic regression model were used to analyze the relationship between PD-L1, Ki67 expression and clinicopathological characteristics in NSCLC patients, while survival curve was applied to evaluate the association between PD-L1 and Ki67 expression and prognosis in patients with NSCLC. Results Among 90 NSCLC patients, there were 62 (68.89%) patients with PD-L1 positive expression and 28 (31.11%) with negative expression, whereas 58 (64.44%) patients were with positive expression and 32 (35.56%) with negative expression of Ki67. PD-L1 expression was higher in patients with squamous cell carcinoma, poorly differentiated tumor, and lymph node metastasis (P < 0.05). The expression of Ki67 was higher in females, patients with squamous cell carcinoma, and those with poorly differentiated tumors (P < 0.05). Logistic regression analysis showed that the patient’s pathological classification, degree of tumor differentiation, and lymph node metastasis were the influencing factors of high PD-L1 expression (P < 0.05). However, the patient’s gender, pathological classification, degree of tumor differentiation were contributory factors of high expression of Ki67 (P < 0.05). The 2-year survival rate of patients in the PD-L1 positive expression group (48.39%) was lower than that of the PD-L1 negative expression group (78.57%) (P < 0.05). To be specific, the corresponding median survival time of patients with positive and negative expression of PD-L1 was 42 and 65 weeks (P < 0.05). The survival rate of patients in the Ki67 positive expression group (48.27%) was as well lower than that in the Ki67 negative expression group (75.00%) (P < 0.05), and the median survival time for the two groups was 41 and 66 weeks respectively (P < 0.05). Conclusions In NSCLC patients, there was high expression of PD-L1 and Ki67 in pathological tissues. The pathological classification, tumor differentiation, and lymph node metastasis were related to PD-L1 high expression, while the gender, pathological classification, and tumor differentiation were related to Ki67 high expression. Furthermore, the prognosis of patients with negative PD-L1 and Ki67 expression was better than that of patients with positive expression.