The Relationship Between The Expression Of Programmed Death Ligand 1(PD-L1) And Clinicopathological Parameters And The Prognosisin Human Breast Cancer

Objective:To compare the expression of PD-L1 in triple-negative breast cancer,non-triple-negative breast cancer and paracancerous tissuessystematically and its correlation with clinicopathological parameters,and to explore the relationship between the expression of PD-L1 and the survival of different types of breast cancer and whether it has predictive value.Methods:1、We selectedbreast cancer patients after pathological diagnosis in the Jiangxi Tumor Hospital,collected their paraffin blocks and adjacent tissues and collected detailed pathological data and clinical data.2 、To analysis the relationship between PD-L1 and clinical pathological parameters and prognosis,we detected the expression of PD-L1 in breast cancer tissues and paracancerous tissues by immunohistochemistry.3、Statistics were carried out using SPSS software(version 19.0 of SPSS).The correlation between the expression of PD-L1 and clinicopathological parameters were assessed using Spearman’s rank correlationcoefficient.The cumulative survival rates were calculatedusing the Kaplan–Meier method and the univariate analysiswerecompared with the log-rank test.The multivariate regressionanalysis were used COX regression model.Statistical tests were twosided,and P<0.05 were considered significantly.Results:1、PD-L1 was expressed in 24.5%(27/110)breast cancer and in 36%(18/50)triple-negative breast cancer.Logistic regression single factor analysis showed that the expression of PD-L1 was significantly associated with the number of positive lymph nodes,AJCC primary tumor classification(TNM),ER status,PR status and surgical methods.The expression of PD-L1 was positively associated with TNM staging,the number of positive lymph nodes,as well as negative ER and PR status.The expression of PD-L1 was disparate in different surgical methods.The expression of PD-L1 in breast cancer patients undergoing modified radical mastectomy was higher than undergoing breast-conserving surgery,with statistical differences.The expression of PD-L1 in triple-negative breast cancer was higher than non-triple-negative breast cancer,with statistical significance.The presence of PD-L1 was not associated with age,tumor size,Ki-67,tumor site,sex,histological grade,menstrual status and whether chemotherapy.Multivariate analysis showed that PD-L1 expression correlated with the number of positive lymph nodes and TNM staging.2、In univariate survival analyses,the number of positive lymph nodes,tumor size,TNM staging,ER status,PR status,molecular typing and PD-L1 expression had an impact on the overall survival.The Overall survival was negatively associated with tumor size,TNM staging,PD-L1 expression,more positive lymph node,as well as positive ER and PR status.The overall survival was related to molecular typing.Among them,positive expression of PD-L1 in triple negative breast cancer and luminal B type breast cancer was associated with worseoutcome.Multivariate COX regression analysis showed that PD-L1 remained an independent negative prognostic factor for OS.3、There was significant difference in the expression of PD-L1 between the triple negative breast cancer(18/50),the her-2subtybe breast cancer(5/20),the luminalB subtybe breast cancer(4/20),the luminalA subtybe breast cancer(0/20)and paracancerous tissues(0/30)(P=0.006).Conclusions:1 、PD-L1 expressed differently in different types of breast cancer.The expression of PD-L1 in the triple-negative breast cancer was significantly higher than other types of breast cancer2、PD-L1 expression was positively associated with TNM staging,more positive lymph node number,as well as negative ER and PR status.It was associated with molecular typing and surgical methods.3、The Overall survival was negatively associated with tumor size,TNM staging,PD-L1 expression,more positive lymph node number,as well as positive ER and PR status.4、The expression of PD-L1 in breast cancer was an independent negative prognostic factor.