The Expression And Clinical Significance Of PD-L1 And EGFR In Cholangiocarcinoma

Objective:The subject is mainly to study the expression of programmed death ligand-1(PD-L1)and epidermal growth factor receptor(EGFR)in cholangiocarcinoma and adjacent normal tissues and to analyze whether there was a relevance between their expression and clinicopathological factors in patients with cholangiocarcinoma,next explore their roles in the occurrence,development,and prognosis of cholangiocarcinoma,and finally look for a valuable molecular target of early diagnosis,treatment,and prognosis of cholangiocarcinoma.Methods:From January 2015 to June 2020,50 cases were collected and sorted out in strict accordance with the criteria of inclusion and exclusion through resecting surgically tissue of patients who were diagnosed with cholangiocarcinoma by pathology as the experimental group at the Department of Hepatobiliary,Pancreatic and Splenic Surgery,People’s Hospital of Inner Mongolia Autonomous Region.In the control group,the normal bile duct tissues that were adjacent to cancer and pathologically confirmed to be negative from the same wax block specimen were selected.After a test for the expression of PD-L1 and EGFR in two groups of specimens combined with the clinicopathological characteristics of the patient’s medical record data(including the patient’s age,gender,tumor location,tumor size,degree of differentiation,lymphatic metastasis,T stage,vascular invasion,CA199 expression level)by immunohistochemical staining(Immunohistochemistry,IHC),that verify the relationship between the expression level of PD-L1 and EGFR and the clinicopathological characteristics of patients.At the same time,we followed up patients with cancer to explore the risk factors that suggest prognosis in patients with cholangiocarcinoma.The results were analyzed using SPSS 22.0 statistical software that was the SPEARMAN analysis method used for the correlation between PD-L1 and EGFR expression in cancer tissues.Kaplan-Meier survival analysis describes the survival outcome of patients and maps them.The log-rank method performs survival analysis,calculates median survival and screens univariate factors related to prognosis,and incorporates univariate clinical characteristics of P<0.05 into the COX ratio Multivariate analysis.It turned out that the factors with P<0.05 were identified as independent risk factors affecting the survival and prognosis of patients.Results:1.The expression of PD-L1 protein in cholangiocarcinoma tissues and adjacent normal tissues is different.It was that the expression is stronger in cancer tissues,and the results are statistically different(P=0.001).PD-L1 protein expression level is correlated with poorly differentiated tumors(P=0.014),positive lymphatic metastasis(P=0.001),T stage(T3+T4)(P=0.033),positive vascular invasion(P=0.021),CA199 expression level ≥39 U/m L(P=0.002)with statistical differences.The expression of PD-L1 protein is not related to the patient’s age(P=0.558),gender(P=0.320),tumor location(P=0.984),and tumor size(P=0.368)and the results were not statistically different.2.There are differences in the expression of EGFR protein in cholangiocarcinoma tissues and normal adjacent tissues.The expression is higher in cancer tissues,and the results are statistically different(P=0.001).The expression level of EGFR protein is related to age ≥60(P=0.002),poorly differentiated tumor(P=0.001),positive lymphatic metastasis(P=0.001),CA199 expression level ≥39U/m L(P=0.044),but EGFR protein expression level is no significant correlation with the patient’s gender(P=0.251),tumor location(P=0.685),tumor size(P=0.133),T stage(P=0.434),vascular invasion(P=0.520)and the results have no statistically significant difference.3.The high expression of PD-L1 and EGFR in cholangiocarcinoma tissue is positively correlated,and there is a statistical difference(correlation coefficient R=0.347,P=0.013<0.05),indicating that the expression of PD-L1 and EGFR presents a synergistic effect.4.The univariate results of the patient showes: PD-L1 high expression,EGFR high expression,age ≥60 years,poor tumor differentiation,positive lymphatic metastasis,T stage(T3+T4),positive vascular invasion,preoperative CA199≥39 U /m L are related to the poor prognosis of patients,and the results are statistically different.Multivariate results show that high PD-L1 expression,high EGFR expression,positive vascular invasion,and CA199 expression level ≥39 U/m L are considered to be independent risk factors by the prognosis of patients after cholangiocarcinoma surgery.Conclusion:1.PD-L1 is highly expressed in cholangiocarcinoma tissue;PD-L1 expression level is correlated with a poorly differentiated tumor,positive lymphatic metastasis,T stage(T3+T4),positive vascular invasion,and CA199 expression level ≥ 39 U/m L,suggesting PD-L1 is involved in the formation and invasion of cholangiocarcinoma.2.EGFR is highly expressed in cholangiocarcinoma tissues;EGFR expression levels are correlated with age ≥ 60,poorly differentiated tumors,positive lymphatic metastasis,and CA199 expression levels≥39 U/m L,indicating that EGFR plays a role in the occurrence and proliferation of cholangiocarcinoma.3.The expression of PD-L1 and EGFR in cholangiocarcinoma tissues is positively correlated.It is speculated that they may become new indicators that play a role in the formation and survival of cholangiocarcinoma.4.High expression of PD-L1 and EGFR,positive vascular invasion,and CA199 level ≥39 U/m L are considered to be independent risk factors affecting the survival and prognosis of patients with cholangiocarcinoma and can indicate the prognosis of patients.