| Objective:This study intends to analyze the similarities and differences of PD-L1 and CD8 expression in endometrioid carcinoma tissues of different microsatellite states in China,and further explore the influence of microsatellite instability on the microenvironment of endometrial cancer tumors.Unstable status as a predictor of the efficacy of immunotherapy.Methods:Patients with endometrial cancer treated by concurrent surgery in the Affiliated Hospital of Binzhou Medical College from January 2016 to September 2018 were selected as subjects.138 cases of endometrial cancer patients who had been tested for MMR protein were screened by case inquiry system,2 cases with tumor history or simultaneous ectopic tumors were excluded.HE slices and MMR protein immunization group of 136 patients who were initially included in the experiment were enrolled.The biopsy was repeated by two double-blind methods with pathologists with above-mentioned senior titles and above.According to the results of the final re-reading,they were divided into 116 cases of type ? cancer and 20 cases of type ? cancer.According to the results of MMR protein detection,?,Type ? cancer was divided into microsatellite instability group(MSI group)and microsatellite stability group(MSS group)to analyze the frequency of MSI in two types of cancer and its relationship with type ? and type ? cancer;116 cases of type I cancer were collected.The patient's clinical pathology data was analyzed for its relationship with MSI.Using a wax block of 116 cases of type ? cancer,a 4 micron continuous pathological section was made and the expressions of PD-L1 and CD8 in different microsatellite cases were detected by immunohistochemistry.The relationship between expression and MSI was further analyzed.And analyze the expression localization of PD-L1 in the microenvironment.The count data were analyzed by SPSS 17.0 software.The comparison of clinicopathological features between different groups and the correlation between PD-L1,CD8 expression and MSI were performed by ?2 test(or Fisher exact probability method),P<0.05 was considered statistically significant.significance.Results:1.The overall positive expression rate of MSI in 136 cases of endometrial cancer was 28.68%(39/136).In 116 cases of type ? cancer,the positive expression rate of MSI was 31.90%(37/116).10.00%in type ? cancer,P=0.046.There were no significant differences in the clinicopathological features of age,tissue differentiation,FIGO stage,depth of myometrial invasion,lymph node metastasis and obesity between the MSI group and the MSS group,all P>0.05.2.The positive rate of PD-L1 in the MSI group was 51.35%(19/37),which was significantly higher than that in the MSS group(29.11%(23/79),P=0.020).The positive rate of PD-L1 in the MSI group was 43.2%(16/37),which was significantly higher than that in the MSS group(16.5%,13/79),P=0.002.The positive expression rate of CD8+T cells in the MSI group was 56.76%(21/37),which was significantly higher than that in the MSS group(25.32%,20/79),P=0.001.Conclusion:1.MSI is more common in type ? endometrial cancer.MSI may up-regulate the expression of PD-L1 and CD8 in the microenvironment of type ?endometrial cancer,and mainly affect the expression of PD-L1 in immune cells.The specific mechanism needs further exploration,future research Pay attention to tumor immunity,which may help us improve our understanding of the tumor microenvironment.2.MSI may be a biomarker for high-response treatment of type ? endometrial cancer PD-1/1PD-L1.In clinical practice,MMR should be performed routinely. |
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