结直肠癌肝转移灶中PD-L1基因阳性患者肝切除后的预后相关因素  

Prognosis-related Factors of Colorectal Cancer Patients with Positive PD-L1 Expression in Liver Metastases After Hepatectomy

作　　者：赵正强 陈珑[2] 刘宇杰 田素青[3] ZHAO Zhengqiang;CHEN Long;LIU Yujie;TIAN Suqing(Department of Surgical,Dongfang People's Hospital,Dongfang 572600,China;Department of Oncology,Sanya Central Hospital(The Third People’s Hospital of Hainan Province),Sanya 572000,China;Department of Radiation Oncology,Peking University Third Hospital,Beijing 100191,China)

机构地区：[1]东方市人民医院外科,东方572600 [2]海南省第三人民医院肿瘤内科,三亚572000 [3]北京大学第三医院肿瘤放疗科,北京100191

出　　处：《肿瘤防治研究》2021年第8期782-787,共6页Cancer Research on Prevention and Treatment

摘　　要：目的探讨直肠癌肝转移灶中PD-L1基因阳性患者肝切除术后预后的相关因素。方法回顾性分析68例以手术为主的个体化综合治疗结直肠癌肝转移灶中PD-L1基因阳性患者的临床资料,观察手术治疗后疗效及预后,分析相关因素。结果单因素分析结果显示:无放疗、N分期、RAS基因突变状态、T分期、MMR表达缺失(dMMR)和Duck分期、肝转移灶最长径及肝转移间隔<1年差异有统计学意义(均P<0.05)。多因素分析显示:无dMMR(P=0.012)、Duck分期A(P=0.000)、肝转移间隔>1年(P=0.020)及肝转移灶最长径(P=0.006)为影响直肠癌肝转移灶中PD-L1基因阳性患者术后预后的保护因素。结论直肠癌肝转移灶中PD-L1基因阳性患者的有效治疗仍是手术为主的个体化综合治疗,无dMMR、Duck分期A、肝转移间隔>1年及肝转移灶最长径≤5 cm是术后生存的保护因素。Objective To evaluate the prognosis-related factors of colorectal cancer patients with positive PD-L1 expression in liver metastases after hepatectomy.Methods We reviewed retrospectively the clinical data of 68 colorectal cancer patients with positive PD-L1 expression in liver metastases receiving personalized comprehensive treatment which was mainly consisted of surgical resection.We observed the results and prognosis after surgical resection and analyzed related factors.Results Univariate analysis showed that no radiotherapy,N stage,RAS mutation status,T stage,dMMR,Duck stage,disease free interval from primary to metastases≤12 months and largest hepatic tumor diameter>5 cm had obvious significance(all P<0.05).Multivariate logistic analysis regression revealed that without dMMR(P=0.012),Duck A stage(P=0.000),disease free interval from primary to metastases>12 months(P=0.020)and largest hepatic tumor diameter<5 cm(P=0.006)were independent protective factors for the prognosis of colorectal cancer patients with positive PD-L1 expression in liver metastases after surgical resection.Conclusion Personalized comprehensive treatment which is mainly consisted of surgical resection still has a good effect on colorectal cancer patients with positive PD-L1 expression in liver metastases after hepatectomy.Without dMMR,Duck A stage,disease free interval from primary to metastases>12 months and largest hepatic tumor diameter≤5cm are independent protective factors for patients’prognosis.

关 键 词：结直肠癌 手术 PD-L1基因阳性 肝转移 预后 

分 类 号：R735.3[医药卫生—肿瘤]