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目的观察负性免疫调节分子程序性死亡配体1(programmed death receptor-ligand1,PD-L1)在人子宫颈癌的表达及其与肿瘤内T淋巴细胞浸润的关系。方法免疫组织化学染色观察5例正常宫颈组织、7例高级别宫颈上皮内瘤变(cervical intraepithelial neoplasia,CINⅡ-Ⅲ)组织和67例子宫颈癌组织中PD-L1的表达和淋巴细胞PD-1的表达,免疫荧光染色观察相应组织内浸润的CD4+T和CD8+T细胞数量,TUNEL法检测淋巴细胞凋亡。结果正常子宫颈上皮不表达PD-L1;宫颈瘤变上皮不表达或弱阳性表达PD-L1,70%(47/67)的宫颈癌表达PD-L1。肿瘤内浸润的部分淋巴细胞表达PD-1。子宫颈瘤变上皮与子宫颈鳞状细胞癌PD-L1表达存在明显差异(P<0.01),浅表浸润的子宫颈鳞状细胞癌PD-L1的表达略低于深部浸润的鳞状细胞癌,但无显著差异;PD-L1阳性病例肿瘤局部CD8+T细胞数量显著减少,且PD-L1表达与CD8+T细胞数量明显负相关(r=-0.82,P<0.01),但与肿瘤局部CD4+T细胞数量无明显相关性(r=-0.05,P>0.05);部分PD-L1阳性的子宫颈癌局部浸润的淋巴细胞存在凋亡现象。结论子宫颈癌细胞表达PD-L1,且PD-L1的表达与肿瘤局部浸润的CD8+T细胞数量减少有关,但与浸润的CD4+T细胞数量无关。癌细胞表达PD-L1可能促进了肿瘤内浸润的淋巴细胞凋亡。
Objective To investigate the expression of programmed death receptor-ligand1 (PD-L1) in human cervical carcinoma and its relationship with T-lymphocyte infiltration. Methods The expression of PD-L1 in 5 cases of normal cervical tissue, 7 cases of high grade cervical intraepithelial neoplasia (CINⅡ-Ⅲ) and 67 cases of cervical cancer were observed by immunohistochemical staining and the expression of PD-1 The numbers of infiltrating CD4 + T and CD8 + T cells in the corresponding tissues were observed by immunofluorescence staining. Lymphocyte apoptosis was detected by TUNEL assay. Results PD-L1 was not expressed in normal cervical epithelium; PD-L1 was undeveloped or weakly expressed in cervical neoplasia, and PD-L1 was expressed in 70% (47/67) cervical cancer. Tumor infiltrating lymphocytes partially express PD-1. The expression of PD-L1 in uterine cervical epithelium and cervical squamous cell carcinoma was significantly different (P <0.01). The expression of PD-L1 in superficial infiltrating cervical squamous cell carcinoma was slightly lower than that in deep infiltrating squamous cell carcinoma , But there was no significant difference. The number of local CD8 + T cells in PD-L1 positive cases was significantly decreased, and the expression of PD-L1 was negatively correlated with the number of CD8 + T cells (r = -0.82, P <0.01) The number of CD4 + T cells had no significant correlation (r = -0.05, P> 0.05). Some PD-L1-positive lymphocytes in local infiltration in cervical cancer showed apoptosis. Conclusion The expression of PD-L1 in cervical cancer cells is related to the decrease in the number of CD8 + T cells infiltrated by tumor, but not to the number of infiltrating CD4 + T cells. The expression of PD-L1 in cancer cells may promote the infiltration of lymphocytes in the tumor.