胃癌手术患者血清PD-L1检测对预后的临床意义  

Prognosis and clinical significance of serum PD-L1 in gastric cancer patients

作　　者：韩永军[1] 牛福勇[2] HAN Yong-jun;NIU Fu-yong(Department of Gastroenterology,Yulin First Hospital,Yulin 719000,China;Department of General Surgery,Yulin First Hospital,Yulin 719000,China)

机构地区：[1]榆林市第一医院胃肠外科,陕西榆林719000 [2]榆林市第一医院普外科,陕西榆林719000

出　　处：《中国现代普通外科进展》2020年第11期877-880,890,共5页Chinese Journal of Current Advances in General Surgery

摘　　要：目的:探讨血清PD-L1检测在胃癌患者临床诊断、疗效预测、预后判断中的应用,为临床试验提供一定的参考依据。方法:选取2010年1月-2016年1月收治的102例胃癌手术患者作为研究对象,检测胃癌患者手术后PD-L1水平。将胃癌患者分为PD-L1高水平组(PD-L1>50.3 ng/m L,n=70)和PD-L1低水平组(PD-L1≤50.3 ng/m L,n=32),进行Kaplan-Meier法生存分析。采用多因素分析血清PD-L1水平的影响因素。采用单因素和多因素Cox回归模型进行胃癌患者术后预后影响因素分析,并分析PD-L1对胃癌细胞的侵袭和迁移能力的影响。结果:胃癌患者PD-L1低水平组3年期生存率(81.3%)显著大于PD-L1高水平组(48.6%),差异有统计学意义(P<0.05)。单因素分析结果显示组织学分级、浸润深度、淋巴结转移及血清PD-L1水平是胃癌患者术后预后的影响因素。多因素分析结果显示组织学分级、淋巴结转移及血清PD-L1水平是胃癌患者术后预后的独立影响因素。PD-L1转染组细胞迁移率和细胞侵袭数显著高于阴性对照组和未转染组(P<0.05);PD-L1转染组ALK和PI3K蛋白表达水平显著高于阴性对照组和未转染组(P<0.05)。结论:胃癌手术后患者血清PD-L1水平显著影响患者的预后,其可能机制是通过PI3K/ALK信号通路影响胃癌细胞的侵袭和迁移能力,值得进一步研究。Objective: To investigate serum PD-L1 level in the diagnosis, treatment responseprediction and prognosis of patients with gastric cancer, which providing a reference for further basic research and clinical trials. Methods: From January 2010 to January 2016, 102 patients with gastric cancer were selected as the study subjects, and the PD-L1 levels of patients with gastric cancer were measured. Patients with gastric cancer were divided into two groups: high level of PD-L1(> 50.3 ng/ml) and low level of PD-L1(≤50.3 ng/ml). Kaplan-Meier survival analysis was performed. The levels of serum PD-L1 in patients with different clinicopathological features were compared. Using univariate and multivariate COX regression models Analysis of prognostic factors in patients with gastric cancer after operation. The effects of PD-L1 on the invasion ability and migration of gastric cancer cells were analyzed. Results: The 3-year survival rate of gastric cancer patients with low PD-L1 level(81.3%) was significantly higher than that of PD-L1 high level group(48.6%)(P<0.05). Single factor analysis showed that histological grade, depth of invasion, lymph node metastasis and serum PD-L1 level were the prognostic factors in patients with gastric cancer.Multivariate analysis showed that histological grade, lymph node metastasis and serum PD-L1 level were the prognostic factors in patients with gastric cancer. The cell migration rate and invasion number of PD-L1 Trans group were significantly higher than those of negative control and untransfected groups(P<0.05), and the expression level of ALK and PI3 K protein in PD-L1 Trans group was significantly higher than that of negative control and untransfected groups(P<0.05). Conclusion: The level of serum PD-L1 in patients with gastric cancer after operation significantly affects the prognosis of the patients, and its possible mechanism is to influence the ability of invasion and migration of gastric cancer cells through PI3 K/ALK signaling pathway.

关 键 词：胃癌 可溶性程序性死亡配体-1 生存率 预后 

分 类 号：R735.2[医药卫生—肿瘤]