胃癌组织中HER2、PD-L1的表达与临床病理特征的相关性

目的:检测胃癌组织中人表皮生长因子受体2(HER2)、程序性死亡因子1配体(PD-L1)的表达,并分析其与胃癌患者临床病理特征的相关性。方法:采用分层整群抽样回顾性分析的方法抽取我院2016年1月至2018年12月经手术病理诊断为胃癌的100例原发性胃癌患者,全部患者术后均经病理组织切片免疫组化染色检测其HER2、PD-L1表达,对比不同性别、年龄、肿瘤大小、肿瘤部位、分化程度、病理类型等临床病理特征胃癌患者HER2、PD-L1的表达,分析二者与胃癌患者临床病理特征的相关性。结果:100例胃癌患者中男女比例为2.8:1,年龄60岁占比高,肿瘤大小多超过4 cm,WHO分型以分化不良与分化较好为主,肿瘤部位主要位于胃下2/3,浸润深度多为T4,TNM分期集中在Ⅰ～Ⅲ期,多伴淋巴结转移,几乎无远处转移,多存在脉管侵犯,部分有神经侵犯。100例胃癌患者胃癌组织HER2表达阴性、弱阳性、强阳性检出率分别为42.00%、31.00%、27.00%;PD-L1阴性、阳性检出率分别为57.00%、43.00%。胃癌组织HER2阳性表达、PD-L1阳性表达均高于癌旁正常胃组织,差异有统计学意义(P0.05)。胃癌组织中HER2表达与疾病分化程度呈负相关(r0,P0.05),PD-L1的表达与肿瘤分化程度、浸润深度、与远处转移均呈显著正相关(r0,P0.05)。结论:HER2的阳性表达可能提示胃癌患者较低的恶性程度,PD-L1的高表达可能提示胃癌患者存在远处转移、浸润深度深、恶性程度高。HER2和PD-L1有望成为胃癌患者诊断参考指标及药物干预的靶点。

Correlation of HER2 and PD-L1 Expression in the Gastric Cancer Tissues with the Clinicopathological Features

ABSTRACT Objective: To detect the expression of human epidermal growth factor receptor 2 (HER2) and programmed cell death ligand 1 (PD-L1) in gastric cancer tissues, and to analyze the correlation between HER2, PD-L1 expression and the clinicopathological features. Methods: The stratified cluster sampling retrospective analysis method was adopted. 100 patients with primary gastric cancer who underwent surgical pathological diagnosis of gastric cancer from January 2016 to December 2018 were enrolled. The HER2 and PD-L1 expression of all the patients were detected by immunohistochemical staining of pathological tissue sections after surgery. The expression of HER2 and PD-L1 in gastric cancer patients with different gender, age, tumor size, tumor location, differentiation degree, pathological type was compared. The correlation between HER2, PD-L1 expression and the clinicopathological features in gastric cancer patients was analyzed. Results: The ratio of male to female in 100 patients with gastric cancer was 2.8:1, the proportion of aged >60 was high, and the tumor size was more than 4 cm, the WHO classification was mainly poorly differentiated and well differentiated, the tumor site was mainly located in the 2/3 of the stomach, the depth of infiltration was mostly T4, the TNM stage was concentrated in stage I~III, with lymph node metastasis, almost no distant metastasis, and there were many vascular invasions, and some of them had nerve invasion; The detection rate of negative, weakly positive and strongly positive expression of HER2 in gastric cancer tissues of 100 patients were 42.00%, 31.00% and 27.00%, respectively; The PD-L1 negative and positive detection rates were 57.00% and 43.00%, respectively; Pearson correlation analysis showed that the expression of HER2 in gastric cancer tissues had negative correlation with the degree of disease differentiation (r<0, P<0.05); The positive expression of HER2 and PD-L1 in gastric cancer tissues was higher than that in adjacent normal gastric mucosa (P<0.05); The HER2 expression in gastric cancer tissues had negative correlation with the degree of disease differentiation (r<0, P<0.05), the PD-L1 expression had positive correlation with the tumor differentiation degree, depth of infiltration and distant metastasis (r>0, P<0.05). Conclusion: The positive expression of HER2 may suggest a lower degree of malignancy in gastric cancer patients. The high expression of PD-L1 may indicate that the gastric cancer patients have distant metastasis, deep infiltration depth and high degree of malignancy. HER2 and PD-L1 are expected to be the diagnosis reference index and the target of drug intervention for gastric cancer patients.