尿核基质蛋白22阳性膀胱癌患者免疫微环境状态变化及预后分析  

Changes of immune microenvironment and prognosis of bladder cancer patients with positive urinary nuclear matrix protein 22

作　　者：杜骏飞 韩从辉[2] 郝林[2] 肖志良 贺厚光 Du Junfei;Han Conghui;Hao Lin;Xiao Zhiliang;He Houguang(The Xuzhou Clinical College of Xuzhou Medical University,Xuzhou 221009,China;Department of Urology,Xuzhou Central Hospital,Xuzhou 221009,China)

机构地区：[1]徐州医科大学徐州临床学院,徐州221009 [2]徐州市中心医院泌尿外科,徐州221009

出　　处：《中国医师杂志》2023年第1期6-10,共5页Journal of Chinese Physician

基　　金：国家自然科学基金(81774089);江苏省医学创新团队项目(CXTDA2017048)。

摘　　要：目的探究尿核基质蛋白22(NMP22)阳性膀胱癌患者免疫微环境变化及预后。方法回顾性分析2019年1月至2020年9月于徐州市中心医院就诊并确诊为膀胱癌的患者86例,所有患者均采用胶体金法检测尿NMP22。检测结果阳性的患者为NMP22阳性组,检测结果阴性的患者为NMP22阴性组。对所有入组患者术后的膀胱癌病理组织切片进行多重荧光免疫组化法检测,检测CD8、细胞程序性死亡-配体1(PD-L1)、细胞程序性死亡蛋白-1(PD-1)和PanCK的表达情况。收集入组患者出院后的随访资料,并对患者的随访资料进行单因素和多因素Cox分析。结果NMP22阳性组患者共有69例,NMP22阴性组患者共有17例。NMP22阳性组CD8阳性细胞百分比、PD-L1阳性细胞百分比明显大于NMP22阴性组,差异有统计学意义(均P<0.05)。单因素分析结果显示,肿瘤分期与膀胱癌疾病进展有关(HR=2.67,P=0.017);多变量分析结果显示,NMP22阳性与膀胱癌复发及疾病进展均显著相关(均P<0.05)。结论尿NMP22阳性的膀胱癌患者肿瘤实质中CD8+T细胞密度及PD-L1密度高于尿NMP22阴性的患者。尿NMP22阳性可作为膀胱癌的不良预后因素之一,对于尿NMP22阳性的患者应加强复查力度。Objective To explore the changes of immune microenvironment and prognosis of bladder cancer patients with positive urinary nuclear matrix protein 22(NMP22).Methods Retrospective analysis was made on 86 patients who were diagnosed with bladder cancer in Xuzhou Central Hospital from January 2019 to September 2020.All patients were tested for urinary NMP22 by colloidal gold method.The patients with positive test results were NMP22 positive group,and the patients with negative test results were NMP22 negative group.The expression of CD8,programmed cell death-ligand 1(PD-L1),programmed cell death protein-1(PD-1)and PanCK were detected by multiple fluorescent immunohistochemical method on the pathological tissue sections of all enrolled patients with bladder cancer after surgery.Follow-up data of enrolled patients were collected after discharge,and univariate and multivariate Cox analysis was performed on the follow-up data.Results There were 69 patients in the NMP22 positive group and 17 patients in the NMP22 negative group.The percentage of CD8 and PD-L1 positive cells in NMP22 positive group was significantly higher than that in NMP22 negative group,and the difference was statistically significant(all P<0.05).Univariate analysis showed that tumor stage was correlated with bladder cancer progression(HR=2.67,P=0.017).Multivariate analysis showed that positive NMP22 was significantly correlated with bladder cancer recurrence and disease progression(all P<0.05).Conclusions The density of CD8+T cells and PD-L1 in tumor parenchyma of urinary NMP22 positive bladder cancer patients was higher than that of NMP22 negative patients.Urinary NMP22 positive can be one of the bad prognostic factors of bladder cancer,and the patients with NMP22 positive should strengthen reexamination.

关 键 词：膀胱肿瘤 核基质蛋白22 肿瘤免疫微环境 预后 

分 类 号：R737.14[医药卫生—肿瘤]