PD-L1表达对术后接受氟尿嘧啶用药方案为基础辅助化疗的结直肠癌患者预后影响  

Effect of PD-L1 expression on the prognosis of postoperative colorectal cancer patients receiving ?uorouracil-based adjuvant chemotherapy

作　　者：张德志[1] 刘猛[1] 朱少功[1] 梅家转[2] 季节[1] Zhang Dezhi;Liu Meng;Zhu Shaogong(Department of General Surgery,People's Hospital of Zhengzhou,Zhengzhou 450003)

机构地区：[1]郑州人民医院普外科,河南郑州450003 [2]郑州人民医院肿瘤科,河南郑州450003

出　　处：《中国现代医药杂志》2019年第11期20-24,共5页Modern Medicine Journal of China

摘　　要：目的探讨PD-L1表达对术后接受氟尿嘧啶用药方案为基础辅助化疗结直肠癌患者预后的影响,并初步分析影响总生存的关键因素。方法本研究选择2012年1月~2018年12月我院普外科89例术后接受氟尿嘧啶用药方案为基础辅助化疗的结直肠癌患者。整理患者的基线及接受治疗的预后资料。采用免疫组织化学方法,检测89例患者术后病理组织标本中PD-L1的表达。采用Kaplan-Meier生存分析方法分析PD-L1的表达与患者预后的关系,并通过Cox模型对其他变量进行校正。结果结直肠癌组织中PD-L1的表达较正常组织明显上调,在总生存期(OS)方面,PD-L1高表达组和低表达组的中位总生存期(mOS)分别为3.90年和5.80年,差异有统计学意义(P=0.032)。Cox模型当中除PD-L1的表达外,具有统计学差异的变量为ECOG评分(OR=2.85,P=0.006)、肿瘤分期(OR=3.11,P<0.001)。结论PD-L1的表达可作为术后结直肠癌患者接受氟尿嘧啶用药方案为基础辅助化疗预后的重要指标之一,为结直肠癌的早期诊断、免疫治疗及预后评估奠定基础。Objective To discuss the effect of PD-L1 expression on the prognosis of postoperative colorectal cancer patients receiving fluorouracil-based adjuvant chemotherapy,and analyze the key factors of overall survival preliminarily.Methods A total of 89 patients with colorectal cancer were enrolled from Jan 2012 to Dec 2018 in general surgery.The expression of PD-L1 was determined by immunohistochemistry in postoperative pathological specimens of 89 patients.Kaplan-Meier survival analysis was used to analyze the relationship between PD-L1 expression and prognosis.Other variables were corrected by the Cox regression model.Results The expression of PD-L1 in colorectal cancer tissues was significantly higher than that in normal tissues.In terms of overall survival(OS),the median overall survival(median OS)of the PD-L1 high-expression group and low-expression group were 3.90 years and 5.80 years,respectively,with statistically significant differences(P=0.032).The statistically significant variables in the Cox regression model were ECOG score(OR=2.85,P=0.006)and tumor stage(OR=3.11,P<0.001).Conclusion The expression of PD-L1 should be considered as one of the important indicators of prognosis in patients with colorectal cancer receiving fluorouracil-based adjuvant chemotherapy.This study provides a basis for early diagnosis,immunotherapy,and prognosis assessment of colorectal cancer.

关 键 词：结直肠癌 程序性死亡蛋白配体1 预后 

分 类 号：R73[医药卫生—肿瘤]