PD-L1、VM及MVD在子宫内膜癌中的表达及其与预后的关系  

Expressions of PD-L1,VM and MVD in endometrial carcinoma and their relationship with prognosis

作　　者：张亚军[1] 刘裴丽 蒋欣[1] 闫莉 陈云云 江月[1] 孟凡菲[2] ZHANG Ya-jun(Department of Pathology,Lianyungang Maternity and Child Care Hospital,Lianyungang 222000,China)

机构地区：[1]连云港市妇幼保健院病理科,江苏连云港222000 [2]连云港市妇幼保健院妇科,江苏连云港222000

出　　处：《牡丹江医学院学报》2023年第4期11-16,共6页Journal of Mudanjiang Medical University

基　　金：江苏省连云港市卫生科技项目(ZD202005)。

摘　　要：目的探讨程序性死亡配体-1(programmed death ligand 1,PD-L1)、血管生成拟态(vasculogenic mimicry,VM)及微血管密度(microvessel density,MVD)在子宫内膜癌(endometrial cancer,EC)中的表达,及其与患者预后的关系。方法选取2016年5月至2022年4月,江苏省连云港市妇幼保健院手术切除并经病理证实的子宫内膜癌标本共62例,采用免疫组织化学法检测子宫内膜癌组织中的PD-L1蛋白表达;用CD34和PAS双重染色法检测VM表达;用CD34标记微血管上皮细胞进行微血管密度计数;分析PD-L1、VM、MVD的表达水平与患者临床病理参数的关系;并采用Kaplan-Meier单因素分析三者对患者预后的影响。结果PD-L1蛋白在临床Ⅱ~Ⅲ期组、组织学中-低分化组和肌层浸润≥1/2组中呈高表达(73.7%、66.7%、87.5%),差异有统计学意义(均P<0.05);VM在淋巴结有转移组中呈高表达(77.8%),差异有统计学意义(P<0.05);MVD值在临床Ⅱ~Ⅲ期组、组织学中-低分化组、肌层浸润≥1/2肌层组和淋巴结有转移组中均呈高表达,差异有统计学意义(均P<0.05);Kaplan-Meier单因素分析显示,肿瘤的临床分期、肌层浸润深度、肿瘤直径及淋巴结转移状态均显著影响患者的三年生存率(均P<0.05);PD-L1和VM表达阳性患者的3年生存期均显著低于阴性患者(均P<0.05);MVD高表达组(≥24)患者的3年生存期显著低于低表达组(<24)的患者(P<0.05)。结论PD-L1、VM、MVD在子宫内膜癌病例中的表达水平与其临床病理特征有关,PD-L1、VM表达阳性及MVD值较高的患者预后相对较差,为进一步研究子宫内膜癌的免疫治疗及判断预后提供重要参考。Objective To investigate the expression of programmed cell death protein ligand-1(PD-L1),vasculogenic mimicry(VM),microvessel vessel density(MVD)in endometrial carcinoma(EC),and their relationship with prognosis.Methods From May 2016 to April 2022,62 EC specimens were selected from Lianyungang Maternal and Child Health Hospital and confirmed by pathology.Expression of PD-L1 was detected by immunohistochemical staining.MVD was detected by immunohistochemical CD34 staining.VM was detected by CD34-PAS double staining.The relationship between expression levels of PD-L1,VM,MVD,and clinical pathological parameters was analyzed.The Kaplan-Meier method was used to analyze the prognosis of patients.Results PD-L1 was highly expressed(73.7%,66.7%and 87.5%)in the clinical stageⅡ-Ⅲgroup,moderate-low histological differentiation group,and myometrial invasion≥1/2 group,the difference was statistically significant(P<0.05);VM was highly expressed in the lymph node metastasis group(77.8%),the difference was statistically significant(P<0.05);MVD was highly expressed in clinical stageⅡ-Ⅲgroup,histologically moderate-low differentiation group,myometrial invasion≥1/2 group and lymph node metastasis group,the difference was statistically significant(P<0.05);Kaplan-Meier univariate analysis showed that the 3-year survival rates were significantly associated with the clinical stage,depth of muscular invasion,tumor diameter and lymph node metastasis(P<0.05).The survival rates were significantly lower in those patients with positive expressions of PD-L1,VM(P<0.05),and the survival rates with high levels of MVD(≥24)were lower than those with low levels(P<0.05).Conclusion The expression of PD-L1,VM,and MVD are related to the clinicopathological features of EC.The patients with positive expression of PD-L1,VM,and high MVD levels have a relatively poor prognosis,which provides an important reference for further study of immunotherapy and prognosis in endometrial carcinoma.

关 键 词：子宫内膜癌 PD-L1 血管生成拟态 微血管密度 生存预后 

分 类 号：R737.33[医药卫生—肿瘤]