The clinical significances of PD-1 and PD-L1 expressions in different distant tumor adjacent tissues for selecting safe surgical margins in partial nephrectomy
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摘要: 目的 观察程序性死亡受体-1(PD-1)和程序性死亡配体-1(PD-L1)在肾透明细胞癌及不同距离癌旁组织中的表达,为肾部分切除术中选择安全切除范围提供理论依据。 方法 选取蚌埠医学院第一附属医院泌尿外科2014年6月—2015年7月期间行根治性肾切除术且术后病理证实为透明细胞癌的肾肿瘤患者60例,记录患者一般资料及肿瘤分期,术中留取正常肾组织、肾肿瘤组织及不同距离的癌旁组织(0.5、1.0、2.0 cm),免疫组织化学染色法检测癌组织及各癌旁组织中PD-1和PD-L1表达水平,比较癌组织及不同距离癌旁组织PD-1和PD-L1的表达,并分析不同分期癌旁组织中PD-1和PD-L1的表达情况。 结果 肾透明细胞癌癌组织中存在PD-1和PD-L1表达,且高于正常肾组织;同时PD-1和PD-L1在癌组织中的表达较在各不同距离癌旁组织中表达增高,差异有统计学意义(均P<0.05);癌旁组织PD-1和PD-L1表达强度及阳性率随距癌组织的距离增加而逐渐降低,两者在距肿瘤0.5 cm癌旁组织中的表达均高于1.0 cm癌旁组织,差异具有统计学意义(P<0.05),而两者在距肿瘤1.0 cm和2.0 cm癌旁组织中的表达差异无统计学意义(P>0.05)。此外,距肿瘤1.0 cm癌旁组织中PD-1和PD-L1在不同肿瘤分期组织中的表达差异无统计学意义。 结论 PD-1和PD-L1在肾透明细胞癌组织中表达高于癌旁组织,且与癌组织距离越近,在癌旁组织中的表达越强,癌组织边距1.0 cm是肾部分切除术中肿瘤的安全切除范围。Abstract: Objective To explore the expressions of PD-1 and PD-L1 in renal cell carcinoma and renal tissues adjacent to the tumor (0.5 cm, 1.0 cm and 2.0 cm), and provide the theoretical basis for selecting safe margin during partial nephrectomy surgery. Methods A total of 60 renal cancer patients were selected, who underwent the radical nephrectomy and diagnosed renal clear cell carcinomas by postoperative pathology in urology department of the first affiliated hospital of Bengbu medical college between June 2014 and July 2015. General information and stages of patients were recorded. Normal renal tissues, cancer tissues and precancerous tissues with different distant to cancer were preserved. Immunohistochemistry staining was employed to detect the expressions of PD-1 and PD-L1 in renal tumors and corresponding adjacent tissues. The relationship between the expression of PD-1, PD-L1 and the safe margin of partial nephrectomy surgery was analyzed. Results The expression of PD-1 and PD-L1 in renal clear cell carcinoma was significantly higher than that in adjacent renal tissues. In adjacent tissues, the expression levels were negatively related to the distance from the carcinoma. At the distance of 0.5 and 1.0 cm, the positive rate were significant difference (all P<0.05). At the distance of 1.0 and 2.0 cm, the positive rate were not significant difference (P>0.05). The expression of PD-1 and PD-L1 in renal clear cell carcinoma had no related to tumor stage at the distance of 1.0 cm from the edge of the tumor to adjacent tissues. Conclusion The expressions of both PD-1 and PD-L1 were increased in renal clear cell carcinoma tissues than that in adjacent tissues, and furthermore the expressions in adjacent tissues were negatively associated with distance to the carcinoma tissues. A distance of 1.0 cm maybe an appropriate surgical margin for partial nephrectomy resections.
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Key words:
- Renal clear cell carcinoma /
- Partial nephrectomy surgery /
- PD-1 /
- PD-L1
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