目的：探讨程序性死亡蛋白-配体 1（programmed death ligand-1，PD-L1）和肿瘤浸润淋巴细胞（tumor-infiltrating lymphocyte, TIL）在三阴性乳腺癌（triple-negative breast cancer，TNBC）组织中的水平及其临床意义。方法：收集2015年1月至 2019年1月福建医科大学附属第二医院手术切除的 61 例 TNBC 患者的癌及癌旁组织石蜡标本，用免疫组化法检测癌组织中 PD-L1表达和CD8+ TIL的水平，用卡方检测方法分析TNBC 组织中PD-L1 和 CD8+ TIL 水平与患者临床病理特征及预后的关 系。结果：PD-L1和CD8+TIL在TNBC组织中的阳性率分别为63.9%（39/61）和32.8%（20/61）。PD-L1表达与TNBC患者的肿瘤 大小、淋巴结转移、病理分期、复发与否有明显关联（均P<0.05），与患者的年龄、肿瘤分化程度、脉管侵犯以及Ki67表达水平无明 显关联（均P>0.05）；CD8+ TIL水平与TNBC 患者的肿瘤大小、肿瘤分化程度、淋巴结转移、病理分期、复发与否有明显关联 （均P<0.05），与患者的年龄、脉管侵犯以及Ki67表达水平无明显关联（均P>0.05）。PD-L1和CD8+TIL水平与患者的无进展生存 期（PFS）及总生存期（OS）具有显著相关性（均P<0.05），PD-L1+ 或者缺乏CD8+ TIL与患者更差的PFS及OS相关（均P<0.05）。结 论：TNBC组织中存在较高水平的PD-L1和CD8+TIL，PD-L1阳性表达或缺乏CD8+TIL与肿瘤侵袭性增加相关，也与患者更差的 PFS及OS相关。

Objective: To investigate the level and clinical significance of programmed death ligand-1 (PD-L1) and tumor-infiltrating lymphocyte (TIL) in triple-negative breast cancer (TNBC) tissues. Methods: A total of 61 postoperative paraffin samples of tumor tissues and para-cancerous tissues from TNBC patients who underwent surgical resection during January 2015 and January 2019 were collected from the Second Affiliated Hospital of Fujian Medical University. The PD-L1 expression and CD8+ TIL level were detected by Immunohistochemistry. The relationship between the levels of PD-L1 and CD8+ TIL in TNBC tissues and the clinicopathological features as well as the prognosis of TNBC patients was analyzed by Chi-square test. Results: The positive rate of PD-L1 and CD8+ TIL in TNBC tissues was 63.9% (39/61) and 32.8% (20/61), respectively. The expression of PD-L1 was significantly correlated with tumor diameter, lymph node metastasis, TNM staging and recurrence (all P<0.05), but not significantly correlated with the age of patients, differentiation degree, vascular invasion and Ki67 expression (all P>0.05). The level of CD8+ TIL was significantly correlated with tumor diameter, differentiation degree, lymph node metastasis, TNM staging and recurrence (all P<0.05), but not significantly correlated with the age of patients, vascular invasion and Ki67 expression (all P>0.05). The levels of PD-L1 and CD8+ TIL were significantly correlated with progression-free survival (PFS) and overall survival (OS) of patients (both P<0.05). Positive PD-L1 expression or lack of CD8+ TIL were associated with tumor invasiveness and worse PFS and OS of patients (both P<0.05). Conclusion: High levels of PD-L1 and CD8+ TIL are present in TNBC tissues. The positive expression PD-L1 and lack of CD8+ TIL are both associated with increased tumor invasiveness and worse PFS and OS of patients

国家卫计委青年项目（No.2018-2-26）；泉州市科技计划项目（No.2018Z112）