PD-L1、Sox9和UCA1水平对膀胱癌患者经尿道膀胱肿瘤切除术预后的评估

Evaluation of PD-L1,Sox9,and UCA1 levels for the prognosis of bladder cancer patients after transurethral resection of bladder tumor

目的探讨膀胱癌患者组织中程序性死亡配体-1(programmed death-ligand 1,PD-L1)、性别决定区Y框蛋白9(sex-determining region Y-box 9,Sox9)和尿路上皮癌胚抗原1(urothelial carcinoembryonic antigen 1,UCA1)的表达情况及其与患者经尿道膀胱肿瘤切除术后预后的关系。方法对2020年12月至2022年12月在广西南宁市第一人民医院行经尿道膀胱肿瘤切除术治疗的膀胱癌患者60例和同期膀胱良性病变患者60例进行回顾性分析,分析两组肿瘤和膀胱组织PD-L1、Sox9和UCA1表达情况的差异,并分析上述指标与膀胱癌患者病理特征及预后的关系。结果研究组PD-L1、Sox9和UCA1阳性表达率分别为61.67%、71.67%和75.00%,均明显高于对照组阳性表达率(χ^(2)=14.903、17.678、26.162,P=0.000);PD-L1表达阳性在肌层浸润TNM分期、有淋巴结转移、高级别病理分级中明显更高(χ^(2)=4.345、4.467、8.154,P=0.037、0.035、0.004),Sox9表达阳性在有淋巴结转移、高级别病理分级中明显更高(χ^(2)=4.038、4.418,P=0.045、0.036),UCA1表达阳性肌层浸润TNM分期、有淋巴结转移、高级别病理分级中明显更高(χ^(2)=5.288、6.087、5.051,P=0.022、0.014、0.025);PD-L1、Sox9和UCA1表达阳性组生存时间明显短于且预后5年生存率明显低于表达阴性组(P<0.05)。结论PD-L1、Sox9和UCA1在膀胱癌组织中均会出现高表达情况,与患者TNM分期、淋巴结转移、病理分级等存在密切关系,且高表达患者预后情况较差,临床上可通过上述指标对膀胱癌患者进行病情诊断和预后评估。

Objective To investigate the expression of programmed death-ligand 1(PD-L1),sex-determining region Y-box 9(Sox9)and urothelial carcinoembryonic antigen 1(UCA1)in the tissues of bladder cancer patients and their relationship with the prognosis after transurethral bladder tumor resection.Methods A retrospective analysis was performed for 60 cases with bladder cancer and 60 cases with benign bladder lesions in the First People's Hospital of Nanning who underwent transurethral bladder tumor resection from December 2020 to December 2022,and the differences in expression of PD-L1,Sox9 and UCA1 between the bladder cancer and benign bladder lesions were analyzed,and the relationship between the above indicators and the pathological characteristics and prognosis of bladder cancer patients was analyzed.Results The positive expression rates of PD-L1,Sox9 and UCA1 in the study group were 61.67%,71.67%and 75.00%,respectively,which were significantly higher than those in the control group(χ^(2)=14.903,17.678,26.162,P=0.000).Positive PD-L1 expression was significantly higher in the TNM stage of muscular invasion,lymph node metastasis,and high-grade pathology(χ^(2)=4.345,4.467,8.154,P=0.037,0.035,0.004).Positive expression of Sox9 was significantly higher in the stage of lymph node metastasis and high-grade pathology(χ^(2)=4.038,4.418,P=0.045,0.036).Positive expression of UCA1 was significantly higher in muscular invasive tumors,lymph node metastasis,and high-grade pathology staging(χ^(2)=5.288,6.087,5.051,P=0.022,0.014,0.025).The positive expression of PD-L1,Sox9,and UCA1 was significantly associated with shorter overall survival time and lower 5-year siorvival rate than the negative expression group(P<0.05).Conclusion PD-L1,Sox9 and UCA1 all have high expression in bladder cancer tissues,which are closely related to TNM stage,lymph node metastasis,pathological grade,etc.,and the prognosis of patients with high expression is poor.