| Pert 1:The correlation between the expression of PD-L1&CD155&CD8 and clinicopathological characteristics and patients prognosis in gastric cancerObjective:The expression status of PD-L1,CD155,and CD8 in surgical specimens of 267 gastric adenocarcinoma patients and the correlation with clinicopathological characteristics of this patient were examined by the novel method,while the relationship between their expression and prognosis was further explored.Methods:Surgical specimens from patients at early stages of gastric adenocarcinoma were collected,a total of 267 cases were used to determine the degree of expression levels of PD-L1,CD 155 and CD8 using multiple immunofluorescence assays,its correlation with clinicopathological parameters of patients was analyzed using chi square test,its relationship with patients’ healthy survival was analyzed using Kaplan Meier curves,and the expression levels of PD-L1,CD 155 and CD8 were analyzed.The expression status and clinical disease characteristics and prognostic status of the patients were analyzed using univariate and multiple influencer Cox regression,and P<0.05 for the difference could be performed with certain statistical significance.Results:Both PD-L1 and CD 155 were expressed in gastric cancer tumor cells,and CD8 was also expressed in gastric cancer infiltrating lymphocytes,with high expression rates of 8.23%(22/267),14.98%(40/267),43.44%(116/267),respectively.From the analysis of clinicopathological data,PD-L1 expression was associated with whether patients had died(P=0.001)factors;CD155 expression was associated with mean volume factors of malignancy(P=0.028).PD-L1 was associated with patient survival by Kaplan Meier analysis(P=0.011),and higher PD-L1 expression was associated with longer patient survival;The higher the infiltration of CD8 in the infiltrating lymphocytes of gastric cancer,the longer the sustained survival of patients,and the magnitude of the difference was somewhat clinically statistically significant(P=0.040);There was a trend towards shorter overall survival in patients with higher CD 155 expression,and the magnitude of the difference did not reach clinical statistical significance(P=0.098).Univariate Cox regression analysis suggested that higher tumor stage,deeper invasion,higher number of lymph node metastases,occurrence of distant metastases,low infiltration of CD8 positive cells,low expression of PD-L1 and high expression of CD 155 were poor prognostic factors.Meanwhile,multivariate Cox regression analysis suggested that the stage of the tumor,the number of lymph node metastases and high and low CD8 expression were independent prognostic factors for patient survival.Conclusion:PD-L1 expression levels were positively correlated with patient survival;The degree of CD 8 positive cell infiltration was positively correlated with survival;There was no significant correlation between CD 155 expression levels and prognosis In univariate analysis,high tumor stage,deep invasion,high number of lymph node metastases and occurrence of distant metastasis,less infiltration of CD8 positive cells,low expression of PD-L1 and high expression of CD 155 were identified as poor prognostic factors in patients with gastric cancer.Multivariate analysis showed that the stage of the tumor,the number of lymph node metastases,and the extent of CD8 positive cell infiltration were associated with patient outcome,suggesting that all three could be used as independent factors affecting patient outcome.Part 2:The relationship between the expression of PD-L1&CD155&CD8 and conjoint analysis to forecast patients prognosisObjective:To discuss the relationship between the expression of PD-L1 and the interaction between tumor tissue infiltrating lymphocytes,and to dissect the impact of its practical application in combination with PD-L1 on the prognosis of patient treatment.Methods:Surgical specimens of patients at early stages of gastric adenocarcinoma were collected,a total of 267 cases were developed tissue microarray,staining was performed using multiplex immunofluorescence,after chi square correlation analysis test,dissecting the expression ability of PD-L1 in malignant tissue cells or malignant stroma with CD8,Correlation of CD155;their expression and their impact on patient prognosis were statistically analyzed with Kaplan Meier curves.Results:This analysis revealed that when PD-L1 was expressed on tumor tissue cells,it was concordant with CD8 expression,i.e.when PD-L1 was highly expressed,CD8 showed a highly infiltrative trend with statistically significant differences(P=0.030);When PD-L1 was expressed on tumor cells,it was not parallel to CD155 expression,and when PD-L1 was highly expressed,CD155 expression was not regular and the difference was not statistically significant(P=0.410).Regardless of whether PD-L1 expression was on tumor cells or on tumor stromal cells,when high PD-L1 expression was accompanied by high CD8 positive infiltration,patients had a trend toward improved overall survival and prolonged survival,and the difference was not statistically significant(P=0.071).Notably,regardless of whether PD-L1 was expressed on tumor cells or it was on tumor str-omal cells,the trend of patients’ overall survival was best when high PD-L1 expression was accompanied by high CD155 expression,which was not statistically significant due to too small patient sample size(P=0.167).So the prognosis of patients was better when high expression of PD-L1 was accompanied by low expression of CD155,but worse when low expression of PD-L1 was accompanied by high expression of CD155,the difference was statistically significant(P=0.044).Conclusion:The level of PD-L 1 expression was positively correlated with the degree of CD8 positive cell infiltration.Patients with high expression of PD-L 1 accompanied with low expression of CD155 had a better prognosis,while patients with low expression of PD-L1 accompanied with high expression of CD155 had a poor prognosis,which may provide us with comprehensive assessment of patient prognosis. |
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