张亚军,王海久

胆囊癌作为消化系统恶性程度极高的肿瘤，具有早期诊断困难、进展迅速、预后极差的特点，5年生存率不足15%。程序性死亡配体1作为关键免疫检查点分子，通过与程序性死亡受体1结合介导免疫抑制，在肿瘤免疫逃逸中发挥核心作用。近年来，PD-L1表达与胆囊癌预后的相关性成为研究热点，但现有研究结论存在一定争议。本文系统梳理PD-L1的分子功能、检测技术及胆囊癌免疫微环境特征，重点分析胆囊癌组织中PD-L1的表达规律、与临床病理参数的关联及对预后的影响，深入探讨相关分子机制与研究争议，并展望其在临床诊疗中的应用前景，为胆囊癌的预后评估及免疫治疗提供理论依据。​

胆囊癌；PD-L1；程序性死亡配体；预后；免疫检查点；肿瘤微环境

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