摘要
目的探索补体C3a在晚期肾透明细胞癌免疫治疗中的变化及与疗效的关系。方法收集78例肾透明细胞癌患者组织样本,利用免疫组织化学法检测癌及癌旁组织中补体C3a的表达。酶联免疫吸附实验法检测晚期肾透明细胞癌患者行程序性细胞死亡蛋白1(PD-1)抑制剂治疗前及治疗4个周期后外周血清中补体C3a的浓度,应用实体瘤疗效评价标准1.1版评估治疗效果。结果78例患者中52例C3a表达呈阳性(67%),即肿瘤细胞胞浆和胞膜呈棕黄染色。不同性别、年龄、部位、组织学分级的肿瘤组织补体C3a的表达相近(均P>0.05)。当肿瘤横径>3.5 cm时,补体C3a的表达显著升高(P=0.025),且TNM分期Ⅱ期患者的补体C3a水平同样升高(P=0.015)。60例行PD-1抑制剂治疗的患者中,完全缓解(CR)+部分缓解(PR)24例、疾病稳定(SD)14例、疾病进展(PD)22例。治疗后CR+PR+SD的补体C3a浓度下降,而PD的浓度上升(P<0.001)。PD-1抑制剂治疗后补体C3a下降患者比上升患者无进展生存时间延长(P<0.001)。结论肾透明细胞癌组织高表达补体C3a,补体C3a的表达与分期及肿瘤大小密切相关。在肾透明细胞癌PD-1抑制剂治疗过程中,血清补体C3a浓度变化可一定程度上反映疗效和预后。
Objective To explore the changes of complement C3a and its relationship with therapeutic efficacy in immunotherapy of advanced renal clear cell carcinoma.Methods Tissue samples from 78 renal clear cell carcinoma patients were collected.Immunohistochemistry was used to detect the expression of complement C3a in tumor and adjacent tissues.Enzyme-linked immunosorbent assay method was used to measure the concentration of complement C3a in peripheral serum of advanced renal clear cell carcinoma patients before and after four cycles of programmed cell death protein 1(PD-1)inhibitor therapy.The therapeutic effect was evaluated according to response evaluation criteria in solid tumors version 1.1.Results Among the 78 renal clear cell carcinoma specimens,52 patients showed positive expression of C3a(67%),with brownish-yellow staining in cytoplasm and membrane of tumor cells.There was no difference in the expression of complement C3a in tumor tissues among different genders,ages,locations and histological grades(all P>0.05).When the transverse diameter of the tumor was greater than 3.5 cm,the expression of complement C3a was significantly increased(P=0.025),and it was also elevated in stageⅡpatients according to TNM staging(P=0.015).Among the 60 advanced renal clear cell carcinoma patients who received immunotherapy,there were 24 cases of complete remission(CR)and partial remission(PR),14 cases of stability of disease(SD),and 22 cases of progression of disease(PD).After PD-1 inhibitor therapy,the serum C3a concentration was decreased in the CR+PR+SD patients,while it was increased in the PD patients(P<0.001).The patients with a decrease in complement C3a after PD-1 inhibitor therapy were significantly longer progression-free survival compared to those with an increase in C3a(P<0.001).Conclusions Complement C3a is highly expressed in renal clear cell carcinoma tissues,and its expression is closely related to tumor staging and tumor size.During the PD-1 inhibitor therapy of renal clear cell carcinoma,changes in complement
作者
戴夕超
乐雯雯
邵伟伟
张晨
袁俊
卞伟钢
陈津津
陶累累
Dai Xichao;Yue Wenwen;Shao Weiwei;Zhang Chen;Yuan Jun;Bian Weigang;Chen Jinjin;Tao Leilei(Department of Oncology,Yancheng Clinical College of Xuzhou Medical University,First people′s Hospital of Yancheng,Yancheng 224001,China;Department of Pathology,Yancheng Clinical College of Xuzhou Medical University,First people′s Hospital of Yancheng,Yancheng 224001,China;Department of Clinical Laboratory,Yancheng Clinical College of Xuzhou Medical University,First people′s Hospital of Yancheng,Yancheng 224001,China)
出处
《中华转移性肿瘤杂志》
2023年第4期394-398,共5页
Chinese Journal of Metastatic Cancer
基金
江苏省卫生健康委课题(Z2021041)
江苏省教育厅研究生创新计划(SJCX22-1282)
盐城市课题(YK2018017)
盐城市第一人民医院院课题重点项目(ZD2018004)。
