PD-L1 And FOXM1 Expression In NSCLC And Correlation Analysis Of Clinical Prognosis

Objective:To investigate the expression of PD-L1 and FOXM1 protein in non-small cell lung cancer(NSCLC),and to analyze the correlation between the expression and the clinical features and prognosis of patients,at the same time explore the relationship between the expressions of these two proteins.Then provide a theoretical basis for exploring the curative effect prediction of NSCLC immunotherapy.Methods:We collected paraffin specimens of 80 patients at department of thoracic surgery in the second affiliated hospital of Dalian Medical University between November 2014 to April 2015,which confirmed by surgery and histology for NSCLC,in the meantime we chose 20 cases of para-carcinoma tissues as controls.By immunohistochemical method to detect PD-L1 and FOXM1 protein expression in the organization,and we evaluate the result using cell staining strength multiply the number of positive cells.SPSS 22.0 statistical software was used for data analysis.Chi-square used to analyze the relationship between the expression and the clinical features of patients,Kaplan-Meier methods and Log-rank test for prognostic analysis,Spearman correlation analysis used to analyze the relationship between the expressions of these two kinds of proteins in cancerous tissue.Results:PD-L1 expression mainly located in the cell membrane and cytoplasm,in the NSCLC cancer tissues,56.3%(45/80)showed positive expression,whereas 30%(6/20)in the para-carcinoma tissues,there were significant differences between the two groups(?2=4.412,P<0.05).PD-L1 expression were closely related to tumor size(?2=7.672,P<0.05),lymph node metastasis(?2=5.261,P<0.05),TNM stage(?2=11.506,P<0.05),FOXM1 expression(?2=10.173,P<0.05).Whereas there was no significant correlation with gender,age,smoking history,pathological type,differentiation degree(P>0.05).FOXM1 expression mainly located in the cell nucleus,65%(52/80)showed positive expression in the carcinoma tissue,whereas 40%(8/20)in the para-carcinoma tissues,there were significant differences between these two groups(?2=4.167,P<0.05).FOXM1 expression were closely related to differentiation degree(?2=10.741,P<0.05),lymph node metastasis(?2=7.299,P<0.05),TNM stage(?2=11.747,P<0.05).Whereas there was no significant correlation with gender,age,smoking history,pathological type,tumor size(P>0.05).Kaplan-Meier survival curve analysis showed a significant correlation between relapse free survival(RFS)of patients and PD-L1?FOXM1 expression(log-rank test showed ?2=4.238,P<0.05;?2=4.368,P<0.05),revealed the negative correlation with prognosis.There were no significant differences in overall survival(OS)(P>0.05).Spearman correlation analysis showed significant positive correlation between the expression of PD-L1 and FOXM1(R= 0.357,P< 0.01).Conclusions: 1.PD-L1 and FOXM1 participate in the development of NSCLC.2.PD-L1 and FOXM1 play a role in the invasion and metastasis of NSCLC.3.Increased expression of PD-L1 and FOXM1 are poor predictors of prognosis ofpatients with NSCLC.4.FOXM1 maybe has the regulatory role for PD-L1 in the NSCLC tissues.