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目的:观察脾多肽联合化疗对三阴性乳腺癌免疫功能及程序性死亡受体1(PD-1)/程序性死亡受体-配体1(PD-L1)表达的影响。方法:山西省肿瘤医院2018年3月至2019年2月收治的三阴性乳腺癌改良根治患者40例，分为对照组(n n＝20)及干预组(n n＝20)，对照组采用常规化疗，干预组在常规化疗的基础上加用脾多肽，观察两组治疗前后免疫相关指标及外周血PD-1/PD-L1表达的影响。免疫组织化学法检测三阴性乳腺癌患者癌组织及癌旁组织中PD-1及PD-L1蛋白的表达。体外培养三阴性乳腺癌MDA-MB-231细胞株，流式细胞术检测脾多肽作用后对细胞周期的影响，蛋白质印迹法(Western blot)检测脾多肽作用后对细胞PD-1及PD-L1蛋白表达的影响。多组计数资料比较采用方差分析，两两比较采用n t检验。n 结果:对照组化疗后T细胞总数低于化疗前(59.93±3.43比65.28±3.29，n t＝-4.452，n P<0.05)，差异均有统计学意义，干预组化疗后CD4n +T细胞(41.47±3.67比34.69±3.61，n t＝5.783，n P<0.05)及T细胞总数(69.33±3.59比63.25±3.29，n t＝3.686，n P<0.05)高于化疗前，差异均有统计学意义。干预组化疗后外周血PD-1(5.74±0.52比4.81±0.35，n t＝3.325，n P<0.05)/PD-L1(5.14±0.29比4.30±0.21，n t＝4.453，n P<0.05)低于化疗前，差异均有统计学意义。PD-1(11比2，n χ2＝7.440，n P<0.05)及PD-L1(17比4，n χ2＝10.912，n P<0.05)在三阴性乳腺癌组织中的阳性表达率高于癌旁组织，差异均有统计学意义，PD-1在三阴性乳腺癌中的表达与患者的组织学分级有关(8比3，n χ2＝4.713，n P<0.05)，PD-L1在三阴性乳腺癌中的表达与患者的临床分期有关(11比6，n χ2＝5.966，n P<0.05)，差异均有统计学意义。脾多肽干预后，MDA-MB-231细胞Gn 0/Gn 1期细胞比例降低(n F＝5.998，n P<0.05)，S期比例增高(n F＝10.375，n P<0.05)，PD-1(n F＝32.123，n P<0.05)及PD-L1(n F＝37.550，n P<0.05)蛋白的表达显著降低，差异均有统计学意义。n 结论:脾多肽可改善三阴性乳腺癌化疗患者的T细胞免疫功能，下调患者外周血及细胞株中PD-1/PD-L1的表达。“,”Objective:To study the effects of lienal polypeptide injection combined with chemotherapy on the immune function and programmed death-1 (PD-1)/programmed death ligand-1 (PD-L1) expression in triple negative breast cancer.Methods:From March 2018 to February 2019, a total of 40 patients with triple negative breast cancer undergoing modified radical mastectomy in Shanxi Cancer Hospital were divided into the control group (n n=20) and the intervention group (n n=20). The control group and intervention group received conventional chemotherapy. The intervention group was given lienal polypeptide injection additionally. The immune related indicators and PD-1/PD-L1 in peripheral blood were detected before and after treatment by flow cytometry. Immunohistochemistry was used to detect the expression of PD-1 and PD-L1 protein in cancer tissues and paracancerous tissues of patients with triple negative breast cancer. The triple negative breast cancer MDA-MB-231 cell line was cultured n in vitro. The effect of lienal polypeptide injection on cell cycle was detected by flow cytometry. The effect of lienal polypeptide injection on the expression of PD-1 and PD-L1 protein was detected by Western blotting.n Results:The total number of T cells in the control group decreased significantly after chemotherapy (59.93±3.43 vs. 65.28±3.29, n t=-4.452, n P<0.05). The total number of CD4n + T cells (41.47±3.67 vs. 34.69±3.61, n t=5.783, n P<0.05) and T cells (69.33±3.59 vs. 63.25±3.29,n t=3.686, n P<0.05) in the intervention group increased significantly. Peripheral blood PD-1 (5.74±0.52 vs. 4.81±0.35,n t=3.325, n P<0.05) PD-L1 (5.14±0.29 vs. 4.30±0.21,n t=4.453, n P<0.05) in the intervention group were significantly lower than that before chemotherapy. The positive expression rate of PD-1 (11 vs. 2,n χ2=7.440, n P<0.05) and PD-L1 (17 vs. 4,n χ2=10.912, n P<0.05) in triple-negative breast cancer tissues was significantly increased, and the expression of PD-1 in triple-negative breast cancer was correlated with histological grade (8 vs. 3,n χ2=4.713, n P<0.05). The expression of PD-L1 in triple-negative breast cancer was associated with clinical stage of the patients (11 vs. 6,n χ2=5.966, n P<0.05). After lienal polypeptide injection intervention, the proportion of MDA-MB-231 cells in Gn 0/Gn 1 phase (n F=5.998, n P<0.05) decreased, that in S phase (n F=10.375, n P<0.05) increased, and the expression of PD-1 (n F=32.123, n P<0.05) and PD-L1 (n F=37.550, n P<0.05) protein decreased significantly.n Conclusion:Lienal polypeptide injection can improve the T cell immune function of patients with triple-negative breast cancer given chemotherapy, and down-regulate the expression of PD-1/PD-L1 in peripheral blood and cell lines.