PD-L1在胸段食管鳞状细胞癌中的表达及其与预后关系的研究

发布时间：2018-06-20 11:04

  本文选题：食管鳞状细胞癌 + PD-L1　； 参考：《宁夏医科大学》2017年硕士论文

【摘要】：目的检测PD-L1分子在胸段食管鳞状细胞癌(ESCC)患者癌标本、癌旁标本中的表达情况,分析癌组织PD-L1表达情况与胸段ESCC患者的一般临床病理特征以及生存的关系,从而探讨PD-L1分子是否可以作为判断胸段ESCC患者预后的独立预测指标。材料与方法2007年1月至2011年7月我院肿瘤外科共收住食管癌患者369例,收集其一般临床病理资料,经纳入标准、排除标准删除部分患者后,对198例胸段ESCC患者进行了随访,从104例随访资料完整的患者中随机选取50名患者作为研究对象,调取石蜡标本,再从这50名患者中随机调取10例患者的癌旁石蜡标本作为对照组织,进行免疫组化检测PD-L1的表达情况。结果50例胸段ESCC患者中27例PD-L1表达呈阳性(54%),23例表达呈阴性(46%),10例癌旁组织中1例PD-L1弱阳性表达(10%)。分析比较癌组织PD-L1表达情况与患者的临床病理特征(性别、年龄、民族、饮酒史、吸烟史、身高体重指数、伴随的基础疾病(高血压、糖尿病、冠心病)、淋巴结清扫数目、肿瘤位置、肿瘤大小、手术吻合方式、组织分化程度、浸润深度、淋巴结状态、术后病理分期、术后辅助治疗(放化疗))均无显著性差异(P0.05)。PD-L1阳性表达组患者5年生存率为22.2%(6/27),阴性表达组患者5年生存率为47.8%(11/23),比较5年生存率,结果显示PD-L1表达阳性组与阴性组患者的5年生存期有显著性差异(P0.05),PD-L1阳性表达组患者的5年生存率明显低于PD-L1阴性表达组患者。单因素分析发现肿瘤浸润深度(T1/T2 vs T3/T4)、淋巴结状态、术后病理分期(Ⅰ/Ⅱ期vsⅢ期)、PD-L1表达情况(PD-L1阳性vs PD-L1阴性)具有显著统计学差异(P0.05)。多因素分析显示PD-L1表达情况是胸段ESCC患者预后的独立危险因素(HR=2.845,95%CI:1.300 6.226,P=0.009)。结论1.PD-L1在胸段ESCC患者的癌组织中高表达,癌旁组织低表达。2.PD-L1表达情况与胸段ESCC患者的一般临床病理特征无相关性;肿瘤浸润深度、淋巴结状态、术后病理分期、PD-L1表达情况是胸段ESCC患者预后的重要影响因素;PD-L1过表达与较差的预后相关,PD-L1是胸段ESCC患者不良预后的独立预测指标。
[Abstract]:Objective to detect the expression of PD-L1 molecules in and around the carcinoma of thoracic esophageal squamous cell carcinoma (ESCC), and to analyze the relationship between the expression of PD-L1 and the general clinicopathological features and survival of ESCC patients with thoracic esophageal squamous cell carcinoma (ESCC). To explore whether PD-L1 molecule can be used as an independent predictor of prognosis in patients with thoracic ESCC. Materials and methods from January 2007 to July 2011, 369 patients with esophageal cancer were enrolled in our hospital. The general clinical and pathological data were collected. 198 cases of thoracic ESCC were followed up after inclusion of the criteria and exclusion of some patients. Paraffin wax samples were collected randomly from 104 patients with complete follow-up data, and 10 paraffin specimens from these 50 patients were randomly selected as control tissue. The expression of PD-L1 was detected by immunohistochemistry. Results the expression of PD-L1 was positive in 27 out of 50 cases of thoracic ESCC. The expression of PD-L1 was negative in 23 cases. The expression of PD-L1 was weak in 1 case of 10 paracancerous tissues. The expression of PD-L1 was compared with the clinicopathological features (sex, age, nationality, alcohol consumption, smoking history, body mass index, accompanied diseases (hypertension, diabetes, coronary heart disease, lymph node dissection). Tumor location, tumor size, surgical anastomosis, degree of tissue differentiation, depth of invasion, lymph node status, postoperative pathological stages, There was no significant difference in postoperative adjuvant therapy (radiotherapy and chemotherapy). The 5-year survival rate of patients with positive expression of P0.05N. PD-L1 was 22. 2 / 27. The 5-year survival rate of patients with negative expression was 47.811 / 23. The 5-year survival rate was higher than that of patients with positive expression of PD-L1. The results showed that the 5-year survival rate of PD-L1 positive expression group was significantly lower than that of PD-L1 negative expression group, and the 5-year survival rate of PD-L1 positive expression group was significantly lower than that of PD-L1 negative expression group. Univariate analysis showed that there were significant differences in tumor invasion depth (T 1 / T 2 vs T 3 / T 4), lymph node status, postoperative pathological stage (stage 鈪，

本文编号：2044042