The Research On The Correlation Between The Level Of PD-L1 Expression Of Liver Tissues,Tcm Syndrome And The Liver Pathology With Chronic Hepatitis B

1 Objective By taking advantage of immunohistochemistry SP method, this study attempted to detect the expression level of programmed death ligand 1(PD-L1) in liver tissues of patients with chronic hepatitis b(CHB) and analyze the correlation of PD-L1 expression with the severity of CHB, classification of inflammation and fibrosis of liver in patients with CHB, and discuss the correlation of expression of PD-L1 in CHB patients withdifferent TCM syndrome types.2 Methods 60 patients with chronic hepatitis B that conformed to the diagnostic criteria were classified as well as diagnosed with five TCM differentiation of types. Include: liver stagnation and spleen deficiency type,yang deficiency of spleen and kidney type,yin deficiency of liver and kidney type,damp heat resistance type,stasis resistance network type,where the liver stagnation and spleen deficiency type,yang deficiency of spleen and kidney type,yin deficiency of liver and kidney type classified as partial deficiency group, the other two types classified as partial positive group. All patients underwent liver tissue puncture to clear the liver inflammatory activity grade and fibrosis stage. We chose the immunohistochemistry SP method to detect the expression of PD-L1 in liver tissues. The positive expression regional was measured with Image-Pro Plus 6.0 image analysis system and calculated the mean optical density of PD-1 expression. To analyze the relationship between the expression of PD-L1 in liver tissues, liver inflammation grading, fibrosis stage and the TCM syndromes. At the same time, we set five cases with hepatic hemangioma who need to be hospitalized surgery as a control group.3 Results The study was carried out with a total of 60 patients with CHB being involved.(1)Immunohistochemical staining results showed: There was positive expression in varying degrees of PD-L1 in liver tissue of CHB patients, while the control group was negative. Cases were divided into 5 groups(G0, G1, G2, G3, G4) according to the grades of inflammation and the MOD( ±s) of expression levels of PD-L1 in liver tissue of each group are 3.21±0.57, 8.47±1.37, 12.99±2.36, 17.90±2.41 and 26.29±1.48 respectively; According to the fibrosis stage, cases were divided into 5 groups(S0, S1, S2, S3, S4), and the MOD( ±s) of expression levels of PD-L1 in liver tissue of each group were 3.62±1.13, 8.94±1.26, 14.40±1.69, 19.04±1.39 and 25.24±2.43 respectively. There were significant differences of PD-1 expression among the low-grade chronic hepatitis B, moderate chronic hepatitis B and the severe chronic hepatitis B of each groups(P<0.05). According to the severe extent, cases were divided into 3 groups(CHL?CHM?CHH), and the MOD( ±s) of expression levels of PD-L1 in liver tissue of each group were7.89±2.88,16.06±2.23, 23.84±2.88 respectively, Statistical test results showed that the comparisons of PD-L1 expression level in different groups had statistic differences(P<0.05). The expression level of PD-L1 in liver tissue had positive correlation to grades of inflammation and the correlation coefficient was 0.902(P<0.05); And the expression level of PD-L1 also had positive correlation to fibrosis stage and the correlation coefficient was 0.852(P<0.05). Before the treatment, there is no outstanding difference between the experimental group and control group in the expression level of PD-L1 in liver tissue.(2)The expression level of PD-L1 has some correlation with the different TCM syndrome types: The PD-L1 expression of the liver stagnation and spleen deficiency type was the lowest stasis resistance network type, and stasis resistance network type was the maximum. We found there was statistical difference(P < 0.01) between the liver stagnation and spleen deficiency type and damp heat resist-ance type as well as stasis resistance network type. Compared with the other two groups,the difference was not statistically significant(P>0.05).The liver stagnation and spleen deficiency type,yang deficiency of spleen and kidney type,yin deficiency of liver and kidney type were classified as partial deficiency group, the other two types were classified as partial positive group. The statistical results showed that the expression of PD-L1 in partial positive group was significantly higher than that in partial deficiency group(P<0.01).4 ConclusionIn different stages of CHB patients, the expression level of PD-L1 was different. Its expression increased as the severity of the disease. The PD-L1 expression was positively correlated with the degree of liver inflammation and fibrosis. At the same time, it also has certain relevance with TCM syndrome. To detect the expression of PD-L1 in liver tissue is expected to provide an objective basis for CHB TCM typing, clinical diagnostics, and other aspects of Integrative Medicine.