目的： 可溶性PD-L1（sPD-L1）水平升高与肾细胞癌和多发性骨髓瘤预后相关。然而，sPD-L1在晚期黑色素瘤中的调节作用和功能尚不完全清楚。本研究旨在评估晚期肢端及黏膜黑色素瘤患者循环系统中sPD-L1浓度与预后的关系。方法： 于2012年1月至2015年12月期间在北京大学肿瘤医院招募了未经治疗的晚期肢端及黏膜黑色素瘤患者102例，同时收集40例健康人外周血，使用酶联免疫吸附法测定受试者循环系统中sPD-L1浓度。结果： 晚期黑色素瘤队列包括58名肢端黑色素瘤患者和44名黏膜黑色素瘤患者。患者治疗前血清sPD-L1平均浓度（2.91±2.23 ng/ml）高于健康献血者（0.59 ng/ml）。102例患者中39例（38.2%）患者血清sPD-L1水平显著升高（>2.91 ng/ml），与LDH水平和Tregs数量增加显著相关，P值分别为0.021和0.017。高浓度和低浓度sPD-L1患者的总生存期存在显著差异，分别为8.5个月和11.6个月（P=0.022）。结论： 晚期肢端或黏膜黑色素瘤患者的sPD-L1浓度升高，可能在疗效预测方面发挥重要作用。

Objective: Elevated levels of soluble PD-L1 (sPD-L1) are associated with worse prognosis of renal cell carcinoma and multiple myeloma. However, the regulatory roles and functions of sPD-L1 in advanced melanoma are not fully understood. This study was designed to evaluate the association between circulating sPD-L1 concentrations and prognosis of patients with advanced acral or mucosal melanoma.Methods: A total of 102 untreated patients with advanced acral and mucosal melanoma admitted to Peking University Cancer Hospital between January 2012 and December 2015 were enrolled in this study. In the meanwhile, peripheral blood samples were obtained from 40 healthy donors. Circulating sPD-L1 concentrations were determined using an enzyme-linked immunosorbent assay.Results: The advanced melanoma cohort included 58 acral melanoma patients and 44 mucosal melanoma patients. The pre-treatment concentration of sPD-L1 (2.91±2.23 ng/ml) in plasma of patients group was elevated as compared with that in healthy donors (0.59 ng/ml). The concentration of sPD-L1 in serum was significantly upregulated in 39/102 (38.2%) patients and significantly associated with increased LDH level (P=0.021) and number of Tregs (P=0.017). The overall survival rates of patients with high or low concentrations of sPD-L1 were statistically different (8.5 months [high level] vs 11.6 months [low level], P=0.022).Conclusion: sPD-L1 concentration is elevated in patients with advanced acral or mucosal melanoma, which may play an important role in predicting prognosis.

R739.5；R730.7

北京市自然科学基金资助项目（No. 7202022）