PD-1及TIM-3在早期宫颈癌患者中的表达及与生存预后的关系研究  

Expression of PD-1 and TIM-3 in patients with early cervical cancer and their relationship with survival and prognosis

作　　者：刘苗苗[1] 刘辉辉 贺丽亚[1] 彭丽丽 崔玉洁 王霞[1] 张洪珍[1] LIU Miaomiao;LIU Huihui;HE Liya;PENG Lili;CUI Yujie;WANG Xia;ZHANG Hongzhen(Hebei General Hospital,Shijiazhuang 050051,Hebei,China;Hebei Blood Center,Shijiazhuang 050004,Hebei,China)

机构地区：[1]河北省人民医院,河北石家庄050051 [2]河北省血液中心,河北石家庄050004

出　　处：《现代中西医结合杂志》2022年第21期2963-2969,共7页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：河北省医学科学研究重点课题(20180016)。

摘　　要：目的探讨程序性死亡受体1(PD-1)、T细胞免疫球蛋白黏液素3(TIM-3)在早期宫颈癌组织中的表达情况及二者与宫颈癌临床病理特征的关系,为宫颈癌免疫治疗、监测进展和预后提供新的思路。方法收集2016年1月1日—6月30日在河北省人民医院初治的45例早期宫颈癌患者术后病理标本及临床资料,采用免疫组化法检测宫颈癌组织中PD-1及TIM-3的表达情况。按照PD-1和TIM-3表达情况分为PD-1阳性组、PD-1阴性组、TIM-3阳性组、TIM-3阴性组,比较各组临床病理特征及随访1~4年的生存率,采用log-rank检验进行预后单因素分析;单因素分析有意义的变量进行COX风险比例回归模型预后多因素分析;Pearson分析PD-1和TIM-3的相关性及各因素与二者的相关性。结果宫颈癌组织中PD-1蛋白阳性表达率为73.3%(33/45),TIM-3蛋白阳性表达率为64.4%(29/45)。TIM-3阳性组和TIM-3阴性组比较、PD-1阳性组与PD-1阴性组比较,肿瘤分化程度、是否发生淋巴结转移差异均有统计学意义(P均<0.05)。log-rank检验,PD-1阴性组的中位无病生存期、中位随访生存时间均明显长于PD-1阳性组(P=0.0484,P=0.0450),TIM-3阴性组的中位无病生存期、中位随访生存时间均明显长于TIM-3阳性组(P=0.0160,P=0.0166)。单因素分析显示患者的肿瘤分化程度、是否发生淋巴结转移、PD-1和TIM-3阳性表达情况与患者的无病生存期和随访生存时间均有明显相关性(P均<0.05),且与患者的年龄、随访生存时间有明显相关性(P均<0.05)。多因素分析显示,肿瘤分化程度是患者无病生存期和随访生存时间的独立影响因素(P=0.029,P=0.047)。相关性分析显示,PD-1和TIM-3的表达呈正相关(r=0.497,P=0.001),PD-1和TIM-3与肿瘤分化程度均呈正相关(r=0.400,P=0.006;r=0.396,P=0.007),与是否淋巴结转移均呈负相关(r=-0.312,P=0.037;r=-0.035,P=0.017)。结论早期宫颈癌患者PD-1和TIM-3阳性表达率较高,PD-1和TIM-3的过表达可能Objective It is to explore the expression of programmed death 1(PD-1),T-cell immunoglobulin mucin(TIM-3)in the tissue of early cervical cancer and their relationship with the clinicopathological features of cervical cancer,so as to provide new ideas for immunotherapy,monitoring progress and prognosis of cervical cancer.Methods The postoperative pathological specimens and clinical data of 45 patients with early cervical cancer who were initially treated in Hebei General Hospital from January 1 to June 30,2016 were collected,and the expression of PD-1 and TIM-3 in cervical cancer tissue was detected by immunohistochemistry.According to the expression of PD-1 and TIM-3,they were divided into PD-1 positive group,PD-1 negative group,TIM-3 positive group and TIM-3 negative group.The clinicopathological characteristics and the survival rate of 1 to 4 years of follow-up were compared among each group.The log-rank test was used to analyze the single factor of prognosis;The significant variables after univariate analysis were analyzed by multivariate analysis of prognosis in COX risk proportional regression model;Pearson analysis was used to analyze the correlation between PD-1 and TIM-3 and the correlation between each factor and them.Results The positive expression rates of PD-1 protein and TIM-3 protein in cervical carcinoma were 73.3%(33/45)and 64.4%(29/45),respectively.There were significant differences in tumor differentiation and lymph node metastasis between TIM-3 positive group and TIM-3 negative group,PD-1 positive group and PD-1 negative group(all P<0.05).Log rank test showed that the median disease-free survival(DFS)and median follow-up survival time of PD-1 negative group were significantly longer than those of PD-1 positive group(P=0.0484,P=0.0450),and the median DFS and median follow-up survival of TIM-3 negative group were significantly longer than those of TIM-3 positive group(P=0.0160,P=0.0166).Univariate analysis showed that the degree of tumor differentiation,whether lymph node metastasis occurred,and t

关 键 词：宫颈癌 程序性死亡受体1 T细胞免疫球蛋白黏液素3 预后 

分 类 号：R737.33[医药卫生—肿瘤]