| Objectives Detection of programmed death ligand-1(PD-L1),programmed cell death-1(PD-1)and mismatch repair(MMR)protein expression in colorectal adenocarcinoma tissue,discuss the accuracy and analyzability of the three interpretation methods of PD-L1 and PD-1 protein,in order to improve the accuracy and repeatability of their interpretation.The expression levels in cancer tissues and mononuclear immune cells were analyzed to analyze their relationship with clinicopathological characteristics and prognosis,and the relationship with MMR protein expression.Methods Collected 161 specimens of colorectal adenocarcinoma radical resection in Tangshan Workers' Hospital from 2016 to 2018.Fisher's exact test method analyzed the expression levels of PD-L1 and PD-1 proteins and their relationship with clinicopathological characteristics and MMR protein expression.Cox risk ratio model and Kaplan-Meier survival curve method were used to analyze the survival difference of PDL1 and PD-1 protein positive and negative patients.Results 1.Combined positive score(CPS),tumor positive score(TPS)and mononuclear immune-cell density score(MIDS)were used in 161 colorectal adenocarcinoma specimens.The positive rates of PD-L1 protein expression by the three methods are 91.3%,64.6%,and 90.1%,respectively.The CPS method have the highest positive rate,and the difference is statistically significant(P<0.05).2.CPS method was used to interpret the expression of PD-L1 protein in colorectal adenocarcinoma.The positive rate of male patients(97.9%)is higher than that of female patients(82.1%),the positive rate of T3/T4 patients(95.0%)is higher than T1/T2(65.0%)patients,the positive rate of N1 patients(96.0%)is higher than that of N2 patients(83.3%),and the differences are statistically significant(P<0.05),There is no statistically significant difference in the positive rate of PD-L1 protein expression between different ages,tumor lesions,histological grade,intravascular emboli,nerve invasion,M stage(distant metastasis)(P>0.05).3.TPS method was used to interpret the expression of PD-L1 protein in colorectal adenocarcinoma.The positive rate of T3/T4 patients(61.7%)is higher than that of T1/T2(35.0%)patients,the difference is statistically significant(P<0.05),There is no statistically significant difference in the positive rate of PD-L1 protein expression between different genders,ages,tumor lesions,histological grade,intravascular emboli,nerve invasion,N stage,and M stage(P>0.05).4.MIDS method was used to interpret PD-L1 protein expression in colorectal adenocarcinoma.The positive rate of male patients(97.9%)is higher than that of female patients(79.1%),the positive rate of T3/T4 patients(92.9%)is higher than T1/T2(70.0%)patients,the positive rate of N1 patients(96.0%)is higher than that of N2 patients(80.0%),the differences are statistically significant(P<0.05).There is no statistically significant difference in the positive rate of PD-L1 protein expression between different ages,tumor lesions,histological grade,intravascular emboli,nerve invasion,and M stage(P>0.05).5.The positive rate of colorectal adenocarcinoma with missing MMR protein expression by CPS method(67.7%)is lower than that with no loss of MMR protein expression(93.3%),and the difference is statistically significant(P<0.05).6.The positive expression rates of PD-1 protein by the three methods of CPS,TPS and MIDS are 50.3%,24.2% and 47.8%,respectively.The positive rate of the CPS method is the highest,and the difference is statistically significant(P<0.05).7.The CPS method was used to interpret the expression of PD-1 protein.The positive rate of patients ?60 years old(56.3%)is higher than that of patients <60 years old(33.3%),the positive rate of T3/T4 patients(54.6%)is higher than T1/T2(20.0%)patients,the differences are statistically significant(P<0.05).8.TPS method was used to interpret the expression of PD-1 protein.The positive expression rate of patients ?60 years old(29.4%)is higher than that of patients <60 years old(9.5%),the positive expression rate of T3/T4 patients(27.0%)is higher than T1/T2(5.0%)patients,the differences are statistically significant(P<0.05).9 The MIDS method was used to interpret PD-1 protein expression.The positive rate of patients ?60 years old(54.6%)is higher than that of patients <60 years old(28.6%),the positive rate of T3/T4 patients(51.8%)is higher than T1/T2(20.0%)patients,the differences are statistically significant(P<0.05).There are no statistically significant differences in the positive rates of PD-1 protein expression by CPS,TPS and MIDS in different genders,tumor lesions,histological grade,intravascular emboli,nerve invasion,N stage,and M stage(P>0.05).10.The loss of MMR protein expression is located in the ascending colon(25%)more than other parts,the difference is statistically significant(P<0.05).11.Progression-free survival(PFS)of patients with positive PD-L1 protein expression by CPS method is lower than that of PFS with negative expression of PD-L1 protein by CPS method,the difference is statistically significant(P<0.05).Conclusions 1.The interpretation of PD-L1 and PD-1 protein expression in colorectal adenocarcinoma is best with CPS interpretation method.2.The three interpretation methods of CPS,TPS and MIDS interpret PD-L1,PD-1 protein in T3 and T4 colorectal adenocarcinoma,and the positive rate is higher than that of T1 and T2.CPS and MIDS interpretation methods interpret PD-L1.The positive rate of protein expression in N1 stage colorectal adenocarcinoma is higher than that in N2 stage.The high expression of PD-L1 and PD-1 protein may be related to the aggressiveness of colorectal adenocarcinoma.3.The CPS interpretation method interprets PFS of patients with positive PD-L1 protein expression lower than that of CPS interpretation of patients with negative PD-L1 protein expression,which may be related to the prognosis of patients.Figure 40;Table 8;Reference 133... |
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