The Expression Of PD-L1 And CD8~+Tils In Cervical Squamous Cell Carcinoma Tissue And Its Influence On Prognosis Of Cervical Squamous Cell Carcinoma

Objective:To analyze the expression of PD-L1 and CD8~+Tils density and clinical significance in cervical squamous cell carcinoma,and to explore the indicators that may affect the prognosis of cervical squamous cell carcinoma,and to provide new ideas for better treatment of cervical squamous cell carcinoma.Methods:131 cases of cervical squamous cell carcinoma were surgically removed or biopsy from January 2009 to January 2018 in the First Hospital of Shanxi Medical University.The expression of PD-L1 and CD8~+Tils was observed by immunohistochemistry.The correlation between PD-L1 and CD8~+Til density in cervical squamous cell carcinoma was analyzed by chi-square test or fisher test.The relationship between expression of PD-L1 and CD8~+Tils clinical pathology was analyzed by multivariate Cox regression analysis of expression of PD-L1 and the relationship between clinicopathological features and prognosis.Survival data were analyzed by Kaplan-Meier method and Log-Rank test and the survival curves were drawn.Results:Among the 131 patients with cervical squamous cell carcinoma,the positive rate of PD-L1 was 64.89%(P<0.05).The expression of PD-L1 was not significantly different from the age,differentiation and lymphatic vascular invasion of patients with cervical squamous cell carcinoma(P>0.05),but the tumor size,interstitial infiltration depth,FIGO stage,lymph node metastasis and parametrial infiltration were statistically significant(P<0.05).In 131 cases of cervical squamous cell carcinoma,the median CD8~+Tils was21%/HPF(2-30).CD8~+Tils had a low density was 60 cases(45.80%)and CD8~+Tils a high density was 71 cases(54.20%).In low-density CD8~+Tils cases,85.00%(51/60)of patients had high PD-L1 expression;in CD8~+Tils high-density cases,47.89%(34/71)of patients had high PD-L1 expression.The expression of PD-L1 was significantly correlated with the density of CD8~+Tils(P<0.05).PD-L1/CD8~+Tils density group was associated with tumor size,FIGO stage and lymphatic vascular invasion(P<0.05).There was no significant difference in depth,degree of tissue differentiation,lymph node metastasis and parametrial infiltration in cervical squamous cell carcinoma patients(P>0.05).Of the 131 patients with cervical squamous cell carcinoma,8 were lost to follow-up because of no regular follow-up or telephone number changes.During the follow-up period,32 patients died and the 5-year survival rate was 69.9%.Kaplan-Meier method and Log-Rank test showed that patients with cervical squamous cell carcinoma without lymph node metastasis had better prognosis than patients with lymph node metastasis(P<0.05);patients with cervical squamous cell carcinoma of stage I-IIa had higher than stage IIb-IV.The prognosis of patients with good prognosis was good(P<0.05).The prognosis of patients with moderately differentiated cervical squamous cell carcinoma was better than that of poorly differentiated patients(P<0.05).The prognosis of patients with PD-L1 negative expression was better than that of PD-L1 positive patients(P<0.05).Patients with high-density CD8~+Tils had a better prognosis than patients with low-density CD8~+Tils(P<0.05);the prognosis of PD-L1~-/CD8~+Tils high-density group was the best,and the prognosis of PD-L1~+/CD8~+Tils low-density group Worst(P<0.05).Multivariate analysis showed that the degree of differentiation,lymphatic vascular invasion,lymph node metastasis and FIGO stage were independent factors affecting OS in patients with cervical squamous cell carcinoma(P<0.05).Conclusion:PD-L1 was highly expressed in cervical squamous cell carcinoma.The expression of PD-L1 in cervical squamous cell carcinoma was negatively correlated with the density of CD8~+Tils cells.The prognosis of PD-L1 positive cervical squamous cell carcinoma was lower than that of negative expression.PD-L1 combined with CD8~+Tils density can assess the prognosis of patients with cervical squamous cell carcinoma and and provide new ideas for better treatment of cervical squamous cell carcinoma.