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梁 婷1 黄慧艳2 雷先华1 李 荣1.子宫内膜癌的微卫星不稳定性与PD-L1表达的相关性及临床意义[J].中国现代医生,2021,59(11):122-124
子宫内膜癌的微卫星不稳定性与PD-L1表达的相关性及临床意义
Correlation between microsatellite instability and PD-L1 expression in endometrial carcinoma and its clinical significance
  
DOI:
中文关键词:  子宫内膜癌  微卫星不稳定性  PD-L1 表达  相关性  临床意义
英文关键词:Endometrial carcinoma  Microsatellite instability  PD-L1 expression  Correlation  Clinical significance
基金项目:江西省卫生计生委科技计划项目(20197399)
作者单位
梁 婷1 黄慧艳2 雷先华1 李 荣1 1.江西省赣州市肿瘤医院病理科江西赣州 3410002.江西省于都县人民医院病理科江西于都 342300 
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中文摘要:
      目的 探讨子宫内膜癌的微卫星不稳定性与PD-L1 表达的相关性及临床意义。方法 选取2016 年1 月至2018 年12 月在我院病理库中搜集所有行手术治疗切除子宫的内膜癌标本共120 例,采用免疫组化的方法标记错配修复蛋白MLH1、MSH2、PMS2 和MSH6,检测其表达水平,以(+)和(-)记录各抗体表达情况。采用免疫组化的方法标记PD-L1 蛋白,以(+)和(-)记录抗体的表达情况。统计分析120 例子宫内膜癌患者的微卫星状态与临床病理特征、PD-L1 表达的相关性。结果 120 例子宫内膜癌患者中,MSI 40 例,MSS 80 例,分别占总数的33.3%、66.7%。MSI 和MSS 患者的年龄、体质量指数、病理分期、组织分化程度、肌层浸润深度、淋巴结转移之间比较,差异均无统计学意义(P>0.05)。MSI 患者的子宫内膜癌组织、免疫及肿瘤细胞PD-L1 表达阳性率分别为50.0%、42.5%,明显高于MSS 患者的26.3%、17.5%,差异有统计学意义(P<0.05)。Spearman 相关分析显示,子宫内膜癌的微卫星不稳定性与PD-L1 表达显著相关(P<0.05)。敏感性、特异性和准确性分别为50.0%(20/40)、73.8%(59/80)、65.8%(79/120)。结论 子宫内膜癌的微卫星不稳定性会上调子宫内膜癌组织、免疫及肿瘤细胞PD-L1表达,可以作为PD-1/PD-L1 途径免疫治疗子宫内膜癌的生物标志物。
英文摘要:
      Objective To investigate the correlation between microsatellite instability (MSI) and PD-L1 expression in endometrial carcinoma and its clinical significance.Methods A total of 120 cases of endometrial carcinoma specimens from the pathological database of our hospital from January 2016 to December 2018 were collected.The mismatch repair proteins MLH1,MSH2,PMS2 and MSH6 were labeled by the immunohistochemistry method,and their expression levels were detected.The expression of each antibody was recorded by(+)and(-).The expression of PD-L1 protein was labeled by the immunohistochemistry method,and the expression of antibody was recorded by (+) and (-).The correlation between microsatellite status (MSS) and clinicopathological features and PD-L1 expression in 120 patients with endometrial carcinoma was analyzed statistically.Results Among 120 patients with endometrial carcinoma,there were 40 cases of MSI and 80 cases of MSS,accounting for 33.3% and 66.7% of the total respectively.There were no statistically significant differences between all patients with MSI and MSS in age,body mass index,pathological stage,degree of tissue differentiation,depth of muscle infiltration and lymph node metastasis(P>0.05).The positive rates of PD-L1 expression in endometrial carcinoma tissue,immunity and tumor cells in patients with MSI were 50.0% and 42.5%,which were significantly higher than those of 26.3%,17.5% in patients with MSS,with significant difference(P<0.05).It was shown by Spearman correlation analysis that MSI in endometrial carcinoma was significantly correlated with PD-L1 ex pression(P<0.05).The sensitivity,specificity and accuracy were 50.0%(20/40),73.8% (59/80) and 65.8%(79/120),respectively.Conclusion MSI in endometrial carcinoma can up-regulate the expression of PD-L1 in endometrial carcinoma tissue,immunity and tumor cells,which can be used as a biomarker of PD-1/PD-L1 immunotherapy for endometrial carcinoma.
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