The Relationship Between Expression Of D2-40 And PD-L1 In Papillary Thyroid Carcinoma And Lymph Node Metastasis

Objective:To investigate the relationship between D2-40 labeled micro-lymphoid tube density(MLVD)and programmed death protein-ligand 1(PD-L1)expression in papillary thyroid carcinoma(PTC),nodular goiter(NG)and normal thyroid tissues,and to explore the relationship between them and PTC clinicopathological features and cervical lymph node metastasis,and to find valuable predictors for PTC cervical lymph node metastasis.Method:The tissues of 145 patients undergoing thyroid surgery in the XX Hospital of Jilin University from October 2018 to October 2019 were collected.Among them,100 were PTC and 45 were NG.The normal tissue around the NG tissue was selected as normal thyroid tissue.NG tissue and normal thyroid tissue were used as control group in total 39 cases.Immunohistochemical method was used to detect the expression of PD-L1 and MLVD marked by D2-40 in pathological tissues.Patients were not treated with radiotherapy and chemotherapy before operation,and the pathological results of the tumor whether there was regional lymph node metastasis were determined by the routine pathological results after operation.Result:1.The positive expression rates of PD-L1 in PTC tissues,NG tissues and normal thyroid tissues were 8%(3/39),15%(6/39)and 68%(63/92).The differences between the three groups were statistically significant(P<0.05).The positive expression rates of PD-L1 in NG tissues and normal thyroid tissues were no significant difference(P>0.05).The positive expression rates of NG tissues and normal thyroid tissues wasstatistically significant(P<0.05)compared with the positive expression rate of PTC tissues.2.The MLVD marked by D2-40 in PTC tissues,NG tissues and normal thyroid tissues were(3.44±1.03),(3.76±1.14),(10.34±1.81).The differences between the three groups were statistically significant(P<0.05).The MLVD marked by D2-40 in NG tissues and normal thyroid tissues were no significant difference(P>0.05).The MLVD marked by D2-40 in NG tissues and normal thyroid tissues was statistically significant(P<0.05)compared with the MLVD marked by D2-40 in PTC tissues.3.The positive expression rates of PD-L1 in PTC tissues were associated with tumor size and lymph node metastasis(P<0.05),but were independent with age,sex,membrane infiltration and tumor multifocality(P>0.05).4.The MLVD marked by D2-40 in PTC tissues were associated with lymph node metastasis(P<0.05),but were independent with age,sex,tumor size and membrane infiltration and tumor multifocality(P>0.05).5.The results of Logistic regression analysis showed that the tumor size,MLVD marked by D2-40 and PD-L1 were the influencing factors of PTC lymph node metastasis,but the MLVD marked by D2-40 was the independent influencing factor of lymph node metastasis.ROC curve analysis had a role in predicting PTC lymph node metastasis when MLVD marked by D2-40?10.7(below-curve area of 0.969,P=0.000).6.The expression levels of MLVD marked by D2-40 in PD-L1 positive group and negative group were compared in PTC tissues.the difference was statistically significant(t=-9.960,P=0.000).After the Spearman rank correlation test,the results showed a significant positive correlation between PD-L1 and MLVD marked by D2-40 in the PTC tissues(=0.594,P=0.000).Conclusion:1?The positive expression rate of PD-L1 in PTC tissues was significantly higher than that in normal thyroid and NG tissues,and the positive expression rate of PD-L1 was related to tumor size and lymph node metastasis,suggesting that PD-L1 may be involved in the occurrence and development of PTC and lymph node metastasis.2?The MLVD marked by D2-40 in PTC tissues was significantly higher than that in normal thyroid tissues and NG tissues,and the positive expression of MLVD marked by D2-40 was related to lymph node metastasis,suggesting that the MLVD marked by D2-40 may be related to the occurrence of PTC and lymph node metastasis.3?The tumor size,MLVD marked by D2-40 and PD-L1 are the influencing factors of PTC lymph node metastasis,but the MLVD marked by D2-40 is the independent influencing factor of lymph node metastasis,which suggests that MLVD marked by D2-40 has reference value for predicting PTC lymph node metastasis.5?The MLVD marked by D2-40 in PTC tissues was positively correlated with PD-L1,suggesting that PD-L1 may be associated with the formation of micro-lymphatic vessels.