Abstract:
Objective The molecular mechanism of programmed cell death-ligand 1 (PD-L1) in tumor cells and its clinical value had been widely explored. However, the research of programmed cell death-1 (PD-1) on tumor cells and immune cells was still lacking. Our article aimed to explore the PD-1 expression on immune cells and tumor cells respectively. Otherwise, we also explored the correlation of PD-1 and clinicopathological features, and its recurrence risk in patients with early-stage lung adenocarcinoma.
Methods In this study, patients with early-stage lung adenocarcinoma were enrolled from Guangdong Provincial People's Hospital between April 2010 and June 2021. PD-1 protein expression was assessed by immunohistochemical (IHC) on tumor cells and immune cells, respectively.
Results 446 early-stage lung adenocarcinoma patients meeting the criteria were analyzed. The positive expression rate of PD-1 on tumor cells was 2.2% (10/446), and the positive expression rate of PD-1 on immune cells was 18.2% (81/446). Binary logistics regression analysis showed that positive PD-1 expression on immune cells was more likely to happen in smoking patients (vs. non-smoker) odds ratio (OR) 2.059, 95% confidence interval (CI) 1.138~3.723,
P<0.05, PD-1 positive expression on tumor cells are more likely to happen in stage Ⅲ patients (vs. stageⅠ) (OR: 45.92, 95%CI 5.616~375.507,
P<0.05), and there was a positive correlation between PD-1 expression on tumor cells and PD-1 expression on immune cells (
r=0.58,
P<0.05). Kaplan-Meier survival analysis showed that the patients of tumor cell PD-1 positive expression had a higher risk of recurrence hazard ratio (HR) 6.5, 95%CI 1.227~34.590, disease-free survival (DFS):
P<0.05, and PD-1 expression on immune cells was not related to the risk of recurrence (DFS:
P=0.26).
Conclusions The positive expression of PD-1 on tumor cells may be a poor prognostic factor after surgery in patients with early-stage lung adenocarcinoma.