摘要
目的探讨食管鳞状细胞癌组织中plexin-A4和程序性死亡蛋白-1(PD-1)的表达及其与预后的关系。方法选择2014年3月至2014年12月新乡医学院第一附属医院收治的食管鳞状细胞癌患者80例为研究对象。取所有患者术中切除的食管鳞状细胞癌组织和距癌组织5 cm以上的正常食管鳞状上皮组织(癌旁组织),将一部分标本用甲醛固定后石蜡包埋保存,另一部分冻存于-80℃冰箱待用。采用实时荧光定量聚合酶链反应法检测食管鳞状细胞癌组织和癌旁组织中plexin-A4和PD-1 mRNA表达;采用免疫组织化学法检测食管鳞状细胞癌组织中plexin-A4和PD-1蛋白表达,并分析食管鳞状细胞癌组织中plexin-A4、PD-1蛋白表达与临床病理学特征的相关性;采用Kaplan-Meier、Log-rank检验方法进行单因素生存分析;采用单因素和多因素Cox风险比例模型分析影响食管鳞状细胞癌患者预后的因素。结果食管鳞状细胞癌组织中plexin-A4和PD-1 mRNA相对表达量均显著高于癌旁组织(P<0.05)。plexin-A4主要表达于细胞质,呈棕黄色颗粒;PD-1表达于细胞质和细胞膜,呈棕黄色颗粒。plexin-A4和PD-1蛋白在食管鳞状细胞癌组织中的阳性表达率分别为48.75%(39/80)和75.00%(60/80)。plexin-A4蛋白表达与肿瘤的浸润程度显著相关(P<0.05),与患者的性别、年龄、吸烟、饮酒、病理分型、分化程度、淋巴结转移无关(P>0.05);PD-1蛋白表达与患者的年龄、肿瘤浸润程度、淋巴结转移显著相关(P<0.05),与患者的性别、吸烟、饮酒、病理分型、分化程度无关(P>0.05)。plexin-A4阳性及plexin-A4阴性表达患者的5 a生存率分别为33.33%(20/60)和50.00%(30/60),PD-1阳性及PD-1阴性表达患者的5 a生存率分别为26.67%(16/60)和71.67%(43/60);plexin-A4和PD-1阴性表达患者的5 a生存率显著长于阳性表达患者(χ^(2)=1.461、11.673,P<0.05)。分化程度、淋巴结转移、PD-1表达水平为影响食管鳞状细胞癌患者的独立预后因素(P<0.05);患者的性别、年龄、病理分型、肿瘤浸润程度、plexin-A4表达水平与食管鳞状细胞癌患者生存期无显著相关性(P>0.05)。结论食管鳞状细胞癌组织中plexin-A4和PD-1高表达可能促进食管鳞状细胞癌的发生发展,PD-1可作为监测肿瘤进展、临床治疗及预后评估的指标。
Objective To investigate the expression of plexin-A4 and programmed death-1(PD-1)in esophageal squamous cell carcinoma and their relationship with prognosis.Methods Eighty patients with esophageal squamous cell carcinoma admitted to the First Affiliated Hospital of Xinxiang Medical University from March 2014 to December 2014 were selected as the research objects.The esophageal squamous cell carcinoma tissues and normal esophageal squamous epithelial tissues(paracancerous tissues)which were more than 5 cm away from the cancerous tissues were taked from all patients,and a part of the specimens was fixed with formaldehyde and embed in paraffin for preservation,and the other part specimens was frozen in-80℃refrigerator for use.The expression of plexin-A4 and PD-1 mRNA in esophageal squamous cell carcinoma tissues and paracancerous tissues was detected by real-time fluorescence quantitative polymerase chain reaction method;the expression of plexin-A4 and PD-1 protein in esophageal squamous cell carcinoma tissue was detected by immunohistochemistry,and the correlation between the expression of plexin-A4 and PD-1 protein and clinicopathological characteristics in esophageal squamous cell carcinoma tissue;the Kaplan-Meier and Log-rank test methods were used for univariate survival analysis;the prognostic factors of esophageal squamous cell carcinoma were analyzed by univariate and multivariate Cox risk ratio models.Results The relative expressions of plexin-A4 and PD-1 mRNA in esophageal squamous cell carcinoma tissues were significantly higher than those in paracancerous tissues(P<0.05).plexin-A4 was mainly expressed in the cytoplasm with brown-yellow particles;PD-1 was expressed in the cytoplasm and cell membrane with brown-yellow particles.The positive expression rates of plexin-A4 and PD-1 protein in esophageal squamous cell carcinoma tissues were 48.75%(39/80)and 75.00%(60/80),respectively.The expression of plexin-A4 protein was significantly correlated with the degree of infiltration of turmor(P<0.05),but not related to the gender,age,smoking,drinking,pathological type,degree of differentiation and lymph node metastasis of patients(P>0.05);the expression of PD-1 protein was significantly correlated with the age,degree of infiltration and lymph node metastasis(P<0.05),but not related to gender,smoking,drinking,pathological typing and degree of differentiation(P>0.05).The 5-year survival rates of patients with plexin-A4 positive and plexin-A4 negative expression were 33.33%(20/60)and 50.00%(30/60),respectively.The 5-year survival rates of patients with PD-1 positive and PD-1 negative expression were 26.67%(16/60)and 71.67%(43/60);the 5-year survival rates of patients with negative expression of plexin-A4 and PD-1 were significantly longer than those of patients with positive expression(χ^(2)=1.461,11.673;P<0.05).The differentiation degree,lymph node metastasis,PD-1 expression level were independent prognostic factors affecting patients with esophageal squamous cell carcinoma(P<0.05);the gender,age,pathological type,degree of invasion and plexin-A4 expression level were not significantly correlated with the survival time of patients with esophageal squamous cell carcinoma(P>0.05).Conclusion The high expression of plexin-A4 and PD-1 in esophageal squamous cell carcinoma tissue may promote the occurrence and development of esophageal squamous cell carcinoma,and the expression of PD-1 can be used as an indicator for monitoring tumor progression,clinical treatment and prognostic evaluation.
作者
王淼
曹克鑫
陈志军
张景航
甘绍印
常勇生
李文华
王忠民
WANG Miao;CAO Kexin;CHEN Zhijun;ZHANG Jinghang;GAN Shaoyin;CHANG Yongsheng;LI Wenhua;WANG Zhongmin(Department of Thoracic Surgery No.1 Ward,the First Affiliated Hospital of Xinxiang Medical University,Weihui 453100,Henan Province,China;Henan Key Laboratory of Nerve Repair,Weihui 453100,Henan Province,China;Department of Pathology,the First Affiliated Hospital of Xinxiang Medical University,Weihui 453100,Henan Province,China;Department of Gastroenterology No.1 Ward,the First Affiliated Hospital of Xinxiang Medical University,Weihui 453100,Henan Province,China)
出处
《新乡医学院学报》
CAS
2021年第7期666-670,共5页
Journal of Xinxiang Medical University
基金
河南省医学科技攻关计划联合共建项目(编号:LHGJ20200514)。
