PD-L1、HIF-1α在三阴乳腺癌中表达的意义及其与中医体质分类的关联性研究
发布时间：2019-01-22 13:13
【摘要】：目的:1、研究三阴乳腺癌(TNBC)中PD-L1和HIF-1α蛋白的表达及其与临床病理参数、生存预后的相关性。探讨二者共表达在TNBC中的预后价值;2、调查TNBC的中医体质分布特点,分析体质与PD-L1、HIF-1α表达及患者生存预后的相关性。方法:1、收集福州总医院2010年1月至2013年12月手术病理确诊为TNBC的患者103例,收集入组患者的临床病理资料并随访其生存预后情况;2、采用免疫组织化学方法检测PD-L1和HIF-1α的表达情况;3、运用中华中医药学会的《中医体质分类与判定表》对患者进行中医体质辨识和分类;4、采用SPSS 20.0统计软件对结果进行统计分析。结果:1、TNBC 中 PD-L1 和 HIF-1α的阳性率分别为 30.1%(31/103)和 54.4%(56/103),二者表达呈正相关(r=0.559,P=0.000)。PD-L1表达与肿瘤大小、淋巴结转移、肿瘤分期显著相关(P=0.004、0.009、0.000);HIF-1α表达与年龄、肿瘤大小、组织学分级、淋巴结转移、肿瘤分期显著相关(P=0.007、0.000、0.000、0.001、0.000)。Kαplαn-Meier生存曲线和Log-Rαnk分析显示:肿瘤大小、TNM分期、淋巴结转移情况及肿瘤PD-L1、HIF-1α表达可影响 TNBC 患者的 3 年 DFS(P=0.01、0.000、0.000、0.000、0.000),进一步多因素分析显示:仅肿瘤PD-L1表达与TNM分期为TNBC患者的独立预后不良因素(P-0.016、0.002)。2、TNBC中PD-L1和HIF-1α不同的表达组合可影响患者的生存预后,共表达组即双阳组3年DFS率显著低于未共表达组即单阳组及双阴组(P=0.000),三组生存曲线出现明显分离。3、TNBC体质由多到少依次为:气郁质、血瘀质、痰湿质、湿热质、气虚质和阴虚质。各体质类型中PD-L1与HIF-1α表达无显著差异(P=0.892、0.700),各体质类型3年DFS无显著差异(P=0.655)。结论:1、PD-L1和HIF-1α在TNBC中高表达,且二者表达呈正相关。PD-L1和HIF-1α表达均与不良预后相关,但仅PD-L1可作为TNBC患者的独立预后不良因素。2、PD-L1和HIF-1α共表达患者3年DFS显著低于未共表达患者,TNBC中二者共表达提示预后不良。3、TNBC人群体质均为偏颇体质,气郁质和血瘀质所占比例最大(54.3%)。中医体质分类与PD-L1/HIF-1α表达无明显相关,与TNBC患者的生存预后无明显相关。
[Abstract]:Objective: 1. To study the expression of PD-L1 and HIF-1 伪 protein in (TNBC) and its correlation with clinicopathological parameters and survival prognosis. To explore the prognostic value of co-expression of PD-L1,HIF-1 伪 in TNBC. 2. To investigate the distribution of TCM physique of TNBC, and to analyze the correlation between constitution and PD-L1,HIF-1 伪 expression and survival prognosis of patients. Methods: 1. 103 patients with TNBC were collected from January 2010 to December 2013 in Fuzhou General Hospital. The clinicopathological data of the patients were collected and their survival and prognosis were followed up. (2) the expression of PD-L1 and HIF-1 伪 was detected by immunohistochemical method. 4. The results were analyzed by SPSS 20.0 software. Results: 1the positive rates of PD-L1 and HIF-1 伪 in TNBC were 30.1% (31 / 103) and 54.4% (56 / 103), respectively. The expression of PD-L1 was positively correlated with tumor size and lymph node metastasis. There was a significant correlation between tumor stage and tumor stage (P < 0.004 / 0. 009 / 0. 000). The expression of HIF-1 伪 was significantly correlated with age, tumor size, histological grade, lymph node metastasis and tumor stage (P0. 0070.0000.0000.0000.000). K 伪 pl 伪 n-Meier survival curve and Log-R 伪 nk analysis: tumor size, TNM stage. Lymph node metastasis and tumor PD-L1,HIF-1 伪 expression could affect the DFS of TNBC patients in 3 years. Further multivariate analysis showed that only tumor PD-L1 expression and TNM staging were independent prognostic factors (P-0.016 ~ 0.002). 2different expression combinations of PD-L1 and HIF-1 伪 in TNBC could affect the survival prognosis of TNBC patients. The 3-year DFS rate in the co-expression group (Shuangyang group) was significantly lower than that in the non-co-expression group (single positive group and double-negative group) (P0. 000). Qi deficiency and yin deficiency. There was no significant difference in the expression of PD-L1 and HIF-1 伪 between different physique types (P < 0. 892P 0. 700), but there was no significant difference in 3 years DFS expression among different physique types (P 0. 655). Conclusion: 1 the expression of PD-L1 and HIF-1 伪 in TNBC is highly expressed, and the expression of PD-L1 and HIF-1 伪 is positively correlated with the poor prognosis, but only PD-L1 can be used as an independent factor of poor prognosis in TNBC patients. The DFS in patients with PD-L1 and HIF-1 伪 co-expression in 3 years was significantly lower than that in patients without co-expression. The co-expression of TNBC and TNBC indicated that the prognosis was poor. 3. The population constitution of PD-L1 and HIF-1 伪 was biased, the proportion of qi stagnation and blood stasis was the largest (54.3%). There was no significant correlation between TCM constitution classification and PD-L1/HIF-1 伪 expression, and there was no significant correlation between TCM constitution classification and survival and prognosis of TNBC patients.
【学位授予单位】：福建中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R737.9
[Abstract]:Objective: 1. To study the expression of PD-L1 and HIF-1 伪 protein in (TNBC) and its correlation with clinicopathological parameters and survival prognosis. To explore the prognostic value of co-expression of PD-L1,HIF-1 伪 in TNBC. 2. To investigate the distribution of TCM physique of TNBC, and to analyze the correlation between constitution and PD-L1,HIF-1 伪 expression and survival prognosis of patients. Methods: 1. 103 patients with TNBC were collected from January 2010 to December 2013 in Fuzhou General Hospital. The clinicopathological data of the patients were collected and their survival and prognosis were followed up. (2) the expression of PD-L1 and HIF-1 伪 was detected by immunohistochemical method. 4. The results were analyzed by SPSS 20.0 software. Results: 1the positive rates of PD-L1 and HIF-1 伪 in TNBC were 30.1% (31 / 103) and 54.4% (56 / 103), respectively. The expression of PD-L1 was positively correlated with tumor size and lymph node metastasis. There was a significant correlation between tumor stage and tumor stage (P < 0.004 / 0. 009 / 0. 000). The expression of HIF-1 伪 was significantly correlated with age, tumor size, histological grade, lymph node metastasis and tumor stage (P0. 0070.0000.0000.0000.000). K 伪 pl 伪 n-Meier survival curve and Log-R 伪 nk analysis: tumor size, TNM stage. Lymph node metastasis and tumor PD-L1,HIF-1 伪 expression could affect the DFS of TNBC patients in 3 years. Further multivariate analysis showed that only tumor PD-L1 expression and TNM staging were independent prognostic factors (P-0.016 ~ 0.002). 2different expression combinations of PD-L1 and HIF-1 伪 in TNBC could affect the survival prognosis of TNBC patients. The 3-year DFS rate in the co-expression group (Shuangyang group) was significantly lower than that in the non-co-expression group (single positive group and double-negative group) (P0. 000). Qi deficiency and yin deficiency. There was no significant difference in the expression of PD-L1 and HIF-1 伪 between different physique types (P < 0. 892P 0. 700), but there was no significant difference in 3 years DFS expression among different physique types (P 0. 655). Conclusion: 1 the expression of PD-L1 and HIF-1 伪 in TNBC is highly expressed, and the expression of PD-L1 and HIF-1 伪 is positively correlated with the poor prognosis, but only PD-L1 can be used as an independent factor of poor prognosis in TNBC patients. The DFS in patients with PD-L1 and HIF-1 伪 co-expression in 3 years was significantly lower than that in patients without co-expression. The co-expression of TNBC and TNBC indicated that the prognosis was poor. 3. The population constitution of PD-L1 and HIF-1 伪 was biased, the proportion of qi stagnation and blood stasis was the largest (54.3%). There was no significant correlation between TCM constitution classification and PD-L1/HIF-1 伪 expression, and there was no significant correlation between TCM constitution classification and survival and prognosis of TNBC patients.
【学位授予单位】：福建中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R737.9
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