摘要
Abstract
Objective In order to explore the relationship between the expression of programmed cell death protein ligand 1(PD-L1)and the dermatoscopic manifestations and histopathology of patients with plaque psoriasis,and the potential of PD-L1 as a biomarker to predict the prognosis of patients with plaque psoriasis.Methods A total of 144 patients with psoriasis treated in our hospital from January 2021 to January 2024 were selected as the research objects.All patients were divided into good recovery group(n=91)and poor recovery group(n=53)according to the prognosis level of the patients.The expression levels of PD-L1 protein in psoriasis and normal tissues were compared,and the relationship between PD-L1 protein expression and histopathologic features of patients were statistically compared.The level of PD-L1 messenger RNA(mRNA)under different influencing factors was analyzed by hierarchical regression,and the prognostic factors of plaque psoriasis were analyzed by univariate analysis.The relationship between PD-L1 mRNA expression and dermoscopic expression was explored.Independent correlation analysis and subgroup analysis were performed for PD-L1 mRNA expression and prognosis.The dose relationship between PD-L1 protein expression and poor prognosis in patients with plaque psoriasis was explored.Results There were 96 patients with low expression of PD-L1 protein in plaque psoriasis,and 48 patients with high expression of PD-L1 protein(66.67%vs 33.33%,P<0.001).The expression of PD-L1 protein in psoriasis was correlated with disease course,disease stage,tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β),immunoglobulin E(IgE),psoriasis area and severity index(PASI),maximum epidermal thickness(ETmax)and minimum suprapapillary epidermis thickness(SPETmin)off(P<0.001).Disease course,disease stage,TNF-α,IL-1β,IgE,PASI,ETmax and SPETmin had significant positive effects on PD-L1 mRNA levels(P<0.05).Disease course,disease stage,IgE,PASI,ETmax,SPETmin and PD-L1 mRNA were the prognoses of plaque psoriasis(P<0.05).Spearman analysis showed that background color,scale score,vascular manifestation score and total dermoscopy score had statistically significant effects on PD-L1 mRNA.There was an independent correlation between PD-L1 mRNA expression and prognosis in psoriasis.Subgroup analysis showed that PD-L1 mRNA expression was stably correlated with prognosis in psoriasis tissues at different disease course,disease stage,IgE,PASI,ETmax and SPETmin.Restricted cubic splines(RCS)model analysis showed that PD-L1 protein expression was negatively correlated with poor prognosis in patients with plaque psoriasis.Conclusion The expression of PD-L1 in plaque psoriasis tissues is low,which is closely related to dermoscopic manifestations and histopathology,and can be used as a biomarker to predict the prognosis of patients with plaque psoriasis.关键词
细胞程序性死亡-配体1/斑块状银屑病/皮肤镜/组织病理Key words
Programmed cell death protein ligand 1/Plaque psoriasis/Dermoscope/Histopathology分类
医药卫生
