摘要
目的探究Ⅱ/Ⅲ期微卫星高度不稳定性(MSI-H)结直肠癌(colorectal cancer,CRC)组织中PD-L1、CD8蛋白的表达及临床意义。方法采用多重荧光PCR结合毛细管电泳技术检测61例结直肠癌微卫星状态,并应用免疫组化技术检测结直肠癌肿瘤组织及癌旁组织中PD-L1、CD8蛋白的表达。采用Kaplan-Meier生存曲线法进行结直肠CD8及肿瘤组织PD-Ll表达的生存分析。结果以MSI-H CRC组为实验组,以MSI-L及MSS为对照组;MSI-H CRC在结肠癌、黏液腺癌及低分化癌中更常见。实验组癌组织的PD-L1蛋白表达阳性率为52.0%(13/25),与对照组(16.7%,6/36)比较差异有统计学意义(P=0.003)。实验组癌组织的CD8蛋白表达阳性率为64.0%(16/25),与对照组(44.4%,16/36)比较差异无统计学意义(P=0.510)。PD-L1、CD8在低分化癌和有脉管癌栓的MSI-H CRC中阳性率较高。实验组中PD-L1阴性表达患者无病生存期(DFS)为(14.9±0.9)个月,阳性表达患者DFS为(10.1±0.4)个月,PD-L1阳性表达患者DFS较短(P<0.05)。单因素分析显示分化程度、脉管癌栓、PD-L1、PD-L1+/CD8+是影响MSI-H CRC的复发因素(均P<0.05),多因素分析示PD-L1、PD-L1+/CD8+是影响MSI-H CRC复发的独立危险因素。结论PD-L1、CD8的表达与MSI-H CRC分化和转移密切相关,同时检测结直肠癌的微卫星状态及组织中PD-L1和CD8表达水平,有助于判断MSI-H CRC组织分化程度和转移潜能及评估MSI-H结直肠癌患者预后。
Objective To investigate the correlation between the expression of programmed cell death ligand 1(PD-L1)and CD8 protein in stageⅡ/Ⅲcolorectal cancer with high microsatellitein stability.Methods Microsatellite status was detected in 61 cases of colorectal cancer by fluorescence multiplex polymerase chain reaction combined with capillary electrophoresis.The expression levels of PD-L1 and CD8 in 61 cases of colorectal carcinoma tissues and adjacent colorectal tissues were detected by immunohistochemistry.The correlation between CD8 and PD-L1 expression was evaluated.Univariate analysis for disease-free survival(DFS)was performed using the Kaplan-Meier product-limit method and the survival time difference was compared by the log-rank test.Results The MSI-H colorectal cancer(MSI-H CRC)patients served as the experimental group,while MSI-L/MSS colorectal cancer patients were set as the control group.MSI-H CRC was more common in the colon,mucinous adenocarcinoma,and poorly differentiated carcinoma.The positive rate of PD-L1 protein expression was 52.0%(13/25)in the MSI-H CRC group(experimental group),the difference was statistically significant between the experimental group and the control group(P=0.003).The positive rate of CD8 protein expression was 64.0%(16/25)in the experimental group,with no statistically significant difference between the two groups(P=0.510).The positive expression rate of PD-L1 and CD8 in the experimental group was significantly higher in the MSI-H CRC patients with poorly differentiated carcinoma and vascular tumor emboli.In the experimental group,DFS of patients with negative expression of PD-L1 was(14.9±0.9)months,DFS of patients with the positive expression was(10.1±0.4)months,and DFS of patients with positive expression of PD-L1 was significantly shorter(P<0.05).The univariate analysis showed that the degree of differentiation,vascular tumor emboli,PD-L1,and PD-L1+/CD8+were key factors that influenced the recurrence of the MSI-H CRC(P<0.05).The analysis showed that PD-L1 and PD-L1+/CD8
作者
黄艳
许天文
戴炀斌
林建光
周爽
Huang Yan;Xu Tianwen;Dai Yangbin(Department of Medical Oncology,The Second Affiliated Hospital of Fujian Medical University,Quanzhou 362000,China)
出处
《华中科技大学学报（医学版）》
CAS
CSCD
北大核心
2021年第1期56-61,共6页
Acta Medicinae Universitatis Scientiae et Technologiae Huazhong
基金
福建省卫计委青年科研基金项目(No.2017-2-32)
福建省泉州市科技资助项目(No.2014Z27,No.2018Z099)
泉州市科技局高层次人才科研经费资助项目(No.2018C051R)。
