摘要目的：探讨肺腺癌中程序性死亡分子1（PD－1）及程序性死亡配体1（PD－L1）蛋白表达的情况及与临床病理参数之间的相关性，并分析不同表皮生长因子受体（ EGFR ）基因突变状态与PD－1、PD－L1表达的相关性。方法选取中日友好医院2010年8月至2016年1月间送检的109例浸润性肺腺癌手术标本，其中EGFR基因野生型51例，突变型58例。用免疫组织化学染色检测PD－1、PD－L1的蛋白表达。使用SAS 9．1软件分析实验结果， PD－1与PD－L1表达的相关性分析采用χ2检验，PD－1、PD－L1的表达与临床病理参数的相关性分析采用χ2检验。结果 PD－1、PD－L1蛋白表达总体阳性率分别为68．8％（75／109）和27．5％（30／109），二者之间的相关性具有统计学意义（ P ＜0．05）。 EGFR野生型的51例标本中，PD－1和PD－L1的阳性率（74．5％，39．2％）均高于EGFR突变型的58例标本（63．8％，17．2％），前一组PD－1和PD－L1表达之间的相关性具有统计学意义（P＜0．05），而后一组二者表达的相关性不具有统计学意义（ P＞0．05）。 PD－1的表达与年龄相关（ P＜0．05）。PD－L1阳性表达与组织学分型、肿瘤大小、是否发生淋巴结转移及EGFR状态显著相关（ P＜0．05）。结论不同EGFR状态下，PD－1与PD－L1蛋白表达特点不同。 PD－L1过表达与较大的肿瘤直径及淋巴结转移密切相关，可以作为肺腺癌恶性程度较高的一个提示指标。

abstractsObjective To investigate the expression of programmed cell death-1 ( PD-1 ) and programmed cell death-ligand 1 ( PD-L1 ) in lung adenocarcinoma in correlation with clinical pathological parameters , especially with regard to different epidermal growth factor receptor ( EGFR ) mutation status. Methods One hundred and nine cases of lung adenocarcinoma were collected during the period from Aug . 2010 to Jan. 2016, including 51 cases of EGFR wild type and 58 cases of EGFR mutations. Immunohistochemistry was used to detect PD-1/PD-L1 protein expression. Chi-square test was used to analyze the correlation between PD-1 and PD-L1 expression, and in correlation with clinicopathological parameters.All statistical analyses run by SAS 9.1 software.Results The positive rates of PD-1 and PD-L1 expression were 68.8% ( 75/109 ) and 27.5% ( 30/109 ) , respectively , with significant correlation between the two ( P<0.05 ) .PD-1 and PD-L1 expression rates were higher in 51 cases with EGFR wild type status ( 74.5% and 39.2%) than those in 58 EGFR mutation cases ( 63.8% and 17.2%); PD-1 expression was significantly associated with age ( P <0.05 ); that of PD-L1 was closely correlated with histological type , tumor size , lymph node metastasis and EGFR status ( P<0.05 ) .Conclusions PD-1 and PD-L1 expression profiles and their correlation with EGFR mutations are different from those with native EGFR.PD-L1 overexpression is closely correlated with larger tumor size and lymph node metastasis , suggesting it is a high-grade marker for lung adenocarcinoma .