摘要
目的探讨程序性死亡受体1（PD－1）在非小细胞肺癌（NSCLC）组织中的表达与表皮生长因子受体（EGFR）基因突变和其他临床病理特征之间的关系，以及对患者预后的影响。方法采用免疫组化SP法检测88例NSCLC组织及癌旁组织中PD－1的表达，采用等位基因特异性扩增测序法检测NSCLC组织EGFR的突变情况和突变类型，并分析其与NSCLC临床病理特征和预后的关系。结果PD－1在NSCLC组织中的阳性表达率为63.6%（56/88），明显高于癌旁正常组织（21.6%，19/88；P〈0.05）。EGFR基因突变型43例，突变率为48.9%，其中PD－1阳性表达30例（69.8%）；EGFR基因野生型45例，其中PD－1阳性表达26例（57.8%）。43例EGFR基因突变患者中，19Del突变24例，其中PD－1阳性表达20例（83.3%）；21L858突变19例，其中PD－1阳性表达10例（52.6%）。PD－1在NSCLC组织中的表达与患者是否吸烟、淋巴结转移情况和EGFR基因突变类型有关（均P〈0.05）。全组PD－1阳性和阴性表达患者的中位无进展生存时间分别为7.03和18.66个月，差异有统计学意义（P＝0.007）。在EGFR基因野生型患者中，PD－1阳性和阴性表达患者的中位无进展生存时间分别为25.21和38.24个月，差异有统计学意义（P＝0.024）。在EGFR基因突变型患者中，PD－1阳性和阴性表达患者的中位无进展生存时间分别为21.23和31.44个月，差异无统计学意义（P＝0.128）。结论PD－1在EGFR基因突变型和野生型NSCLC中均有表达，不同基因突变类型中的表达存在差异。PD－1在NSCLC组织中的表达与患者的预后有关，阳性表达患者的预后较差。
ObjectiveTo investigate the relationships between the expression of programmed death 1 （PD-1） and the epidermal growth factor receptor （EGFR） gene mutations in non-small cell lung cancer （NSCLC）. The study also attempted to investigate the clinicopathological features and prognosis in NSCLC patients.MethodsThe expression of PD-1 protein in 88 cases of NSCLC tumor tissues and adjacent tissues was detected by immunohistochemistry. The mutations of EGFR in NSCLC were detected by Polymerase Chain Reaction-Amplification Refractory Mutation System（PCR-ARMS） method. The expression of PD-1 and patients′ clinical characteristics and prognosis were analyzed.ResultsPD-1 was positive in 63.6%（56/88） NSCLC tumor tissues, which was significantly higher than that in adjacent normal tissues （21.6%, 19/88） （P〈0.05）. EGFR gene mutations were found in 43 cases （48.9%）, in which 30 cases （69.8%）were PD-1 positive expression. 45 cases had the wild types of EGFR gene, in which 26 cases （57.8%） were PD-1 positive. There were 24 cases of 19Del EGFR mutations, including 20 cases （83.3%） of PD-1 positive expression. 19 patients had 21L858 EGFR mutations, including 10 cases （52.6%） of PD-1 positive expression. The expression of PD-1 in NSCLC was related to patients′ smoking status, lymph node metastasis and EGFR gene mutations （P〈0.05）. The median progression-free survival time of patients with PD-1 positive and negative expression was 7.03 and 18.66 months, respectively （P=0.007）. In patients with wild-type EGFR gene, the median progression-free survival time of PD-1 positive and negative expression was 25.21 and 38.24 months, respectively. The difference was statistically significant （P=0.024）. The median progression-free survival time in 43 cases of EGFR mutant patients with PD-1 positive and negative expression was 21.23 and 31.44 months. The difference was not statistically significant （P=0.128）.ConclusionsPD-1 expresses in both EGFR mutant and wild-type NSCLC, and its expression levelis different with various EGFR mutations. The expression of PD-1 in NSCLC is related to the prognosis of patients, and the prognosis of patients with positive PD-1 expression was poor.
出处
《中华肿瘤杂志》
CAS
CSCD
北大核心
2017年第6期419-423,共5页
Chinese Journal of Oncology
关键词
癌
非小细胞肺
程序性死亡受体1
表皮生长因子受体
基因突变
Carcinoma, non-small cell lung
Programmed death 1
Epidermal growth factorreceptor
Gene mutation
