目的：探索程序性死亡配体1 (programmed death-ligand 1，PD-L1)在中国非小细胞肺癌（non-small cell lung carcinoma, NSCLC）患者肿瘤组织中的表达水平及影响因素。方法：免疫组织化学法检测2008年4月至2014年8月天津医科大学肿瘤医院122例NSCLC初治患者肿瘤组织中PD-L1、PD-1和CD3+T细胞表达情况，采用χ2和kruskal-wallis检验分析PD-L1表达在临床因素中分布差异性，用Person检验和Spearman检验分析PD-L1表达与EGFR基因型、CD3+T细胞数量及淋巴细胞PD-1表达的相关性，以及原发灶与淋巴结PD-L1表达相关性。结果：所有患者原发灶肿瘤细胞PD-L1表达百分比中位值1.5%（0~93.2%），PD-L1表达在TNM分期分布上有统计学差异（P=0.003），与TNM分期呈显著正相关（r=0.273，P=0.002），与性别、年龄、有无吸烟史、肿瘤最大径、病理类型、CEA水平分布无显著相关（P>0.05）；PD-L1表达水平与CD3+T细胞数量、淋巴细胞PD-1表达水平无相关性，PD-L1表达阴性、低表达和高表达与表皮生长因子受体（epidermal growth factor receptor，EGFR）基因突变亦无显著相关（P>0.05）；48例有淋巴结转移的NSCLC患者原发灶与相应转移淋巴结肿瘤细胞PD-L1表达水平无统计学相关性（P>0.05）。结论：NSCLC患者原发灶肿瘤细胞PD-L1表达在TNM分期分布上有差异，与CD3+T细胞数量、淋巴细胞PD-1表达水平、EGFR基因突变情况无相关性；原发灶与相应转移淋巴结之间肿瘤细胞PD-L1的表达亦没有相关性。

Objective:To explore the expression levels of programmed death-ligand 1 (PD-1) in cancer tissues of the patients with non-small cell lung carcinoma (NSCLC) in China and their influencing factors. Methods: Expressions of PD-L1, PD-1 and CD3+ T cell in tumor tissues from the 122 patients with NSCLC who were hospitalized in the Cancer Hospital of Tianjin Medical University during April 2008 to August 2014 were tested by Immuno histochemistry assay. χ2 and kruskal-wallis tests were used to analyze distribution difference of PD-L1 expression in clinical factors. Person and Spearman tests were to analyze correlation between expression of PD-L1 and EGFR genotype, number of CD3+T cell, expression of lymphocyte PD-1, and correlation between primary cancer focus and expression of lymphatic node PD-L1. Results: Median expression percentage of PD-L1 in cancer cells of primary tumor was 1.5% (0-93.2%) in all of the patients. Distribution of the PD-L1 expression in TNM staging had a very significant difference (P<0.01), expression of PD-L1 positively correlated with TNM staging (r=0.273, P<0.01) and did not significantly correlate with gender, age, smoking history, maximum tumor diameter, pathological type and level of CEA (P>0.05); expression level of PD-L1 did not correlate with number of CD3+ T cell and expression level of lymphocyte PD-1, negative, low and high expression of PD-L1 did not significantly correlate with EGFR gene mutation (P>0.05). There was non correlation of PD-L1 expression levels of cancer cells between primary tumor and corresponding metastasis lymph nodes in the 48 NSCLC patients with lymph node metastasis (P>0.05). Conclusion: PD-L1 expression of primary cancer cells in the patients with NSCLC could have differences in distribution of TNM staging, and don’t have correlation with number of CD3+ T cell, expression level of lymphocyte PD-1 and EGFR gene mutation. Expression of PD-L1 in cancer cells also could not have correlation between primary tumor locus and corresponding metastasis lymph nodes.

国家科技支撑计划资助项目（No.2015BA112B12）；国家自然科学基金项目（No.81272221,No.81401887）