Expression Level And Clinical Significance Of PD-1/PD-l1 In Type Two Hepatic Echinococcosis

Objective:To detect the expression of programmed death molecule-1 and its ligand PD-L1 in peripheral blood serum of patients with hepatic echinococcosis(HE)before and after operation by using enzyme-linked immunosorbent assay(ELISA),and to detect the expression of PD-1/PD-L1 in parafocal tissues(less than 2cm)and normal liver tissues(adjacent to the lesion ≥ 2cm)distances of hepatic alveolar echinococcosis(HAE)by immunohistochemical technique.The mechanism of PD-1/PD-L1 in immune escape of hepatic echinococcosis was analyzed comprehensively.The relationship between the expression level and the progress of hepatic echinococcosis was discussed,which provided a new basis for searching for a new dynamic detection strategy of hepatic echinococcosis.Materials and Methods:The subjects were 81 cases,including 24 cases of hepatic alveolar echinococcosis(HAE)group,27 cases of hepatic cystic echinococcosis(HCE)group and 30 cases of control group(healthy persons).Peripheral blood serum samples and clinical data were collected before and after operation in the experimental group and in the healthy control group.The expression levels of PD-1 and PD-L1 in peripheral blood serum of the three groups were detected by ELISA,and the correlation between PD-1 and PD-L1 and clinical indicators of the case group was analyzed.The expression of PD-1 and PD-L1 in paralesional tissues(< 2cm)and distal normal liver tissues(≥ 2cm)in 24 cases of hepatic alveolar echinococcosis(HAE)were detected by immunohistochemistry.Results:1.In the HAE group,there was no difference in some liver function indexes such as ALT,AST,DBIL between the patients and the normal control group(P>0.05),but there were significant differences in age,white blood cells,TBIL,IBIL between the patients and the control group(P<0.05).In the HCE case group,there were no differences in age,sex,nationality,ALT,AST,DBIL,IBIL,WBC between the patients and the normal control group(P>0.05),while there were significant differences in TBIL between the patients and the control group(P<0.05).2.The concentration of PD-1 in HAE patients before and 5-6,8-10 and 12 days after operation was significantly higher than that in healthy control group(P<0.001),but the concentration of PD-1 in HAE patients over 15 days after operation was higher than that in normal control group,but there was no statistical difference(P = 0.786).3.The concentration of PD-L1 in HAE patients before,5-6,8-10,12 days and more than 15 days after operation was significantly higher than that in healthy control group(P < 0.001).With the prolongation of operation time,the concentration of PD-L1 showed a downward trend(P<0.05).4.The concentration of PD-1 in HCE patients before and 5-6,8-10 and 12 days after operation was significantly higher than that in healthy control group(P<0.001),but the concentration of PD-1 in HCE patients over 15 days after operation was higher than that in normal control group,but there was no statistical difference(P=0.941).5.There was no significant difference in the concentration of PD-L1 between pre-operation and 5-6 days after operation(P=0.105).The concentration of PD-L1 before operation,8-10,12 and 15 days after operation was significantly higher than that in healthy control group(P<0.001).6.There was no significant correlation between the levels of PD-1 and PD-L1 in peripheral serum of patients with HAE and HCE before operation and the indexes of leukocyte,liver function(ALT,AST,TBIL,DBIL,IBIL)of patients(P>0.05).7.The positive expression rate of PD-1 was 75% in the adjacent tissues and 8% in the distal normal liver tissues.There was significant difference between the two groups(P<0.001).The positive expression rate of PD-L1 was 92% in the adjacent tissues and 20% in the distal normal liver tissues.There was significant difference between the two groups(P <0.001).Conclution;The expression levels of PD-1 and PD-L1 in peripheral serum of patients with HAE and HCE were significantly higher than those of healthy people,and the expression of PD-1 and PD-L1 decreased after operation,even decreased to normal level with the prolongation of time.The expression of PD-1 and PD-L1 in paralesional tissues of patients with alveolar echinococcosis was higher than that in distal normal liver tissues.