| Background and ObjectivePrimary liver cancer(PLC)is one of the most common malignant tumors in China at present.The incidence of HCC is in the fourth place,and the cause of death lies in the third place,which poses a serious threat to the life and health of Chinese citizens.In this study,the effects of PD-L1 and lymphocyte percentage on the prognosis of liver cancer were investigated by observing the clinical data of the patients with liver cancer and the PD-L1 expression level of the pathological specimens of the patients with liver cancer.Methods1.From January 2011 to December 2016,87 patients confirmed with hepatocellular carcinoma(HCC)by pathology,which received surgical treatment in the first affiliated Hospital of Nanchang University,were searched by the case-linkage system.The clinical data of the patients before and after operation were compared with each other.The recurrence of tumor after operation were also compared with above datas.2.Immunohistochemical staining of PD-L1 in 87 cases of hepatocellular carcinoma(78 cases of hepatitis B-related and 19 non-HBV-related)liver cancer patients was detected by immunohistochemistry.Results1.In this study,we found that the expression of PD-L1 in HCC tissues was significantly higher than that in paracancerous tissues,and the positive rate was 35 /87(40.2%).2.It was found that in AFP,neutrophil / lymphocytic(N/L),the degree of differentiation,and tumor TNM staging the positive rate of PD-L1 expressionwas higher than that in HCC tissue(P < 0.05).The difference was statistically significant,and were all positively correlated with the positive rate of PD-L1 expression.3.Survival curve analysis showed that the tumor-free survival time,the expression of PD-L1,the ratio of neutrophils and lymphocytes,and the number of lymphocytes were significantly different(P < 0.001,0.009,P < 0.001).The ratio of neutrophils and lymphocytes,the number of lymphocytes and the level of alpha-fetoprotein increased again after operation(P = 0.023?0.011),the difference was statistically significant.4.The results of follow up showed that the anti-recurrence rate of PD-L1 was 21/ 35 / 60.0in pathological specimens,which was higher than the average recurrence rate of 32 / 87 / 36.8,and the difference between the two groups was statistically significant.In the analysis of the clinical data of the patients,we found that the tumor-free survival time of the tumor pathological specimens with PD-L1anti-coloration was shorter(average 2.4 ±0.4 years),which was less than that of the non-colored ones(3.9 ±0.6 years)(p < 0.001).The difference between the two groups was statistically significant.5.In multivariate analysis,the expression of PD-L1,percentage of neutrophils and lymphocytes,and the number of lymphocytes in HCC tissues were significantly correlated with the survival time(P = 0.016,P < 0.001,P < 0.002).In univariate analysis,the expression of PD-L1,percentage of neutrophils and lymphocytes and the number of lymphocytes were significantly related to the survival time of HCC patients(P < 0.001,< 0.001 n 0.017,respectively).ConclusionIt was found that the preoperative neutrophil / lymphocyte ratio,the preoperativ percentage of lymphocyte.and PD-L1 expression were related to the recurrence and poor prognosis of HCC,and the common mechanism might be related to tumor immunity. |
PDF Full Text Request