Objective: To investigate the relationship between PD-L1 expression and the clinicopathologic features and prognosis in triple-negative breast carcinomas (TNBC). Methods: All 142 cases of TNBC were collected from the First Affiliated Hospital of Nanjing Medical University from February 2011 to December 2014, and the surgical excision or biopsy specimens from patients without chemotherapy and radiotherapy were included. Histopathologic analysis of stromal tumor infiltrating lymphocyte (sTIL) was performed on HE sections, and PD-L1 immunohistochemical staining was done with MaxVision. Results: The PD-L1 expression rate was 34.5% (49/142) in tumor cells, and was 62.0% (88/142) in sTIL. The PD-L1 expression in tumor cells was positively correlated with tumor size (r=0.181, P=0.031), Ki-67 index (r=0.211, P=0.012), sTIL (r=0.380, P<0.01) and PD-L1 expression in sTIL (r=0.447, P<0.01). The PD-L1 expression in sTIL was positively correlated with tumor grade (r=0.215, P=0.01), Ki-67 index (r=0.253, P=0.002) and sTIL (r=0.370, P<0.01). The high stromal CD8(+) /FOXP3(+) ratio was significantly associated with improved overall survival (χ(2)=4.186, P=0.041). The high percentage of sTIL was significantly associated with improved overall survival (χ(2)=12.427, P<0.01) and progression-free survival (χ(2)=4.057, P=0.044). Conclusions: In TNBC, PD-L1 expression is positively correlated with Ki-67 and sTIL; the stromal CD8(+) /FOXP3(+) ratio and sTIL are significantly associated with prognosis. The PD-L1 expression, stromal CD8(+) /FOXP3(+) ratio and sTIL are biologically important in TNBC, and all these correlative factors are important potential parameters in assessing immunotherapy for TNBC.
目的： 探讨三阴性乳腺癌(TNBC)肿瘤细胞及间质肿瘤浸润淋巴细胞(sTIL)中PD－L1表达与临床病理特征及患者预后的关系。 方法： 收集南京医科大学第一附属医院2011年2月至2014年12月142例女性三阴性乳腺癌患者资料，均为未经化疗和放疗的手术切除或穿刺组织，经常规石蜡包埋，制作组织芯片，判读HE染色切片sTIL百分比，采用免疫组织化学MaxVision法检测142例TNBC肿瘤细胞及sTIL中的PD－L1表达水平。 结果： 本组TNBC肿瘤细胞PD－L1阳性率为34.5%(49/142)，sTIL中PD－L1阳性率为62.0%(88/142)。肿瘤细胞PD－L1与肿瘤大小(r＝0.181，P＝0.031)、Ki－67(r＝0.211，P＝0.012)、sTIL百分比(r＝0.380，P<0.01)及sTIL中PD－L1表达(r＝0.447，P<0.01)均呈正相关。sTIL中PD－L1与组织学分级(r＝0.215，P＝0.01)、Ki－67(r＝0.253，P＝0.002)、sTIL百分比(r＝0.370，P<0.01)均呈正相关。间质CD8(＋)/FOXP3(＋)与总生存时间明显正相关(χ(2)＝4.186，P＝0.041)。sTIL百分比与总生存时间(χ(2)＝12.427，P<0.01)、无进展生存时间(χ(2)＝4.057，P＝0.044)均明显正相关。 结论： TNBC中PD－L1表达与Ki－67、sTIL百分比呈正相关，间质CD8(＋)/FOXP3(＋)及sTIL百分比均与预后相关，它们将是TNBC重要的潜在生物学指标，对免疫治疗有重要的临床指导价值。.
Keywords: Antigens, CD8; Breast neoplasms; Lymphocytes, tumor-infiltrating; Prognosis.