The Impact To Prognosis With The Expression Of P53 And PD-L1 In Advanced Lung Adenocarcinoma

Background and ObjectivesNon-small cell lung cancer is the most common type of lung cancer, although with the popularity of targeted drugs in clinical,the prognosis of advanced lung cancer patients has significantly improved compared with a decade ago. However, Targeted therapy is only effective in selected patients, and will eventually lead to drugs-resistance. It't make drug immunotherapeutic get attention with anti-PD-1drugs appears, and the expression of PD-L1 in tumor tissue obtained attention,a study suggested that tumor suppressor gene p53 mutations may regulating PD-L1 expression through micro RNA. But the relationship betwwen p53 protein expression,PD-L1 expression with prognosis in lung adenocarcinoma tissue remains unclear.MethodsUse the Immunohistochemistry detecting the expression of programmed death receptor ligand 1(PD-L1) and p53 in lung adenocarcinoma tissue, and to investigate the relationship between PD-L1 and p53 protein expression,and the impact of chemotherapy and prognosis of patients.Research contentCollected the 43 case of IV phase lung adenocarcinoma treatment in the Second Affiliated Hospital of Zhengzhou University from January 2012 to January 2014. Use the Immunohistochemical detect the PD-L1, p53 expression levels of lungadenocarcinoma.Using SPSS statistical analysis software for data processing, using chi-square test(significance level set at ? = 0.05),spearman analyze the relationship of p53,PD-L1 expression and chemotherapy effect in advanced lung adenocarcinoma,Kaplan-Meier method to calculate the survival rate of each group and test the differences by log-rank method. Multivariate analysis using Cox proportional hazards regression.Results1. There was 53.5% of all patients with PD-L1 positive expression 60.5% with p53 positive expression in advanced lung adenocarcinoma. Expect PD-L1 expression was correlated with Ki-67 expression(p = 0.043), there was no relationship between p53 positive expression and other clinical features.2. There was no correlation between PD-L1 expression and p53 expression(rs =0.104, p = 0.506).3. the positive effect of chemotherapy PD-L1 was positively correlated(rs =0.402, p = 0.008). PD-L1 positive median progression-free survival(10 months vs6.9months, p = 0.02) and median overall survival was significantly better than the PD-L1 negative group(23 months vs14.5 months, p = 0.09).4.the positive effect of chemotherapy p53 no correlation(rs =-0.009, p = 0.96),There was no significant difference between p53 positive groups and negative groups no matter the median PFS(8.5 months vs 8.8 months, p = 0.73) or median OS(15months vs17 months, p = 0.895).5.cox regression multivariate analysis shows that Ki-67 expression, PD-L1 expression levels were independent prognostic risk factors of lung adenocarcinoma.Conclusions1.There was no correlation between PD-L1 expression and p53 expression in lung adenocarcinoma.2. Compared with PD-L1 negative expression, the patients with PD-L1 positive expression has better ORR,PFS and overall survival; but there was no significant diference with p53 positive and negative expression.3. PD-L1 is an independent prognostic risk factor for lung adenocarcinoma.