CLINICAL PATHOLOGICAL CHARACTERISTICS OF NON-SMALL-CELL LUNG CANCER AND THE CORRELATION BETWEEN PD-1 EXPRESSION AND TUMOR-RELATED MACROPHAGES

Jianbang Shi¹, Jianwei Wu², Bing Zhou³, Jiaxiu Zhang², Dayou Shi⁴, Feizhou Xu², Fei Xu^{1, *} 

¹Respiratory and Critical Medicine, The First Affiliated Hospital of Nanchang University, 17 Yongwaizheng Street, Donghu District, Nanchang, Jiangxi Province - ²Respiratory Medicine, the First People's Hospital of Jiujiang, Jiangxi Province, No. 48 South Taling Road, Jiujiang, Jiangxi Province - ³Department of Pathology, the First People's Hospital of Jiujiang, Jiangxi Province, No. 48 South Taling Road, Jiujiang, Jiangxi Province - ⁴Department of Oncology, the First People's Hospital of Jiujiang, Jiangxi Province, No. 48 South Taling Road, Jiujiang, Jiangxi Province

Objective: The objective is to investigate the correlation between the expression of tumor-associated macrophages and programmed death receptor-1 (PD-1) in non-small-cell lung cancer (NSCLC) and its clinicopathological features.

Methods: The pathological and normal paracancerous tissues of 20 patients with NSCLC who were treated for the first time and archived in the pathology department of a hospital from September 2013 to November 2014 were selected. The expressions of the tumor necrosis factor α (TNF-α), transforming growth factor-β (TGF-β1) in macrophages, and PD-1 in NSCLC and normal paracancerous tissues were measured using immunohistochemistry. The correlation between the TNF‑α, TGF-β1, and PD-1 expression levels and the clinicopathological features and prognosis of patients with NSCLC was analyzed.

Results: There were many CD₆₈+ macrophages in the normal para-cancer tissues and NSCLC tissues of 20 patients. The positive expression rate of CD₆₈+TNF-α in NSCLC tissues was 35% (7/20), and that of CD₆₈+TNF-α positive in normal para-cancer tissues was 90% (18/20). The difference in positive rates between the groups was statistically significant (P<.05). The positive expression rate of CD₆₈+ TGF-α accounting 1 in NSCLC tissues was 50% (10/20), and that of CD₆₈+ TGF-β1 in normal adjacent tissues was 10% (2/20). The difference in the positive rate between the two groups was statistically significant (P<.05). The positive expression rate of PD-1 in NSCLC tissues was 60% (12/20), and the positive expression rate of PD-1 in normal adjacent tissues was 5% (1/20). The difference in the positive rate between the two groups was statistically significant (P<.05). The expression levels of CD₆₈+TNF-α, CD₆₈+ TGF-β1, and PD-1 were all correlated with the clinical stage and lymph node involvement of patients with NSCLC (P<.05) and were independent of gender, age, tumor type, differentiation degree, and tumor size of patients with NSCLC (P>.05). The 5-year survival rate of patients with NSCLC in the CD₆₈+TNF- α positive expression group was 61.54% (8/13), and the 5-year survival rate of patients with NSCLC in the PD-1 negative expression group was 14.28% (1/7). The difference in the 5-year survival rate between the groups was statistically significant (P<.05). The 5-year survival rate of patients with NSCLC in the CD68+TGF-β1 positive expression group was 10% (1/10), and the 5-year survival rate of patients with NSCLC in the CD₆₈+TGF-β1 negative expression group was 80% (8/10). The difference in the 5-year survival rate between the groups was statistically significant (P<.05). The 5‑year survival rate of patients with NSCLC in the PD-1 positive expression group was 12.50% (1/8), whereas the 5-year survival rate of patients with NSCLC in the PD-1 negative expression group was 66.67% (8/12). The difference in the 5-year survival rate between the groups was statistically significant (P<.05).

Conclusion: In NSCLC, the expression level of PD-1 increases, the number of M1 macrophages decreases, and the number of M2 macrophages increases, all of which are correlated with the prognosis and pathological characteristics of patients with NSCLC.