宫颈癌患者血清SCC-Ag、Tim-4、PD-L1水平与预后的相关性分析

Correlation analysis between serum SCC-Ag,Tim-4,PD-L1 levels and prognosis in patients with cervical cancer

目的分析宫颈癌患者血清鳞状细胞癌抗原(SCC-Ag)、分泌型T细胞免疫球蛋白黏蛋白分子4(Tim-4)、可溶程序性死亡分子1(PD-L1)水平与肿瘤预后的相关性.方法选取2012年1月~2015年1月我院收治的60例宫颈癌患者作为宫颈癌组,50例宫颈上皮内瘤病变(CIN)患者作为CIN组,同时选取同期于我院进行体检的40例健康者作为对照组,检测三组血清SCC-Ag、Tim-4、PD-L1水平,分析其与病理特征的关系,采用Kaplan-Meier法分析不同临床病理特征患者生存率,并采用COX回归分析宫颈癌患者预后的影响因素.结果宫颈癌组血清SCC-Ag、Tim-4、PD-L1水平均显著高于CIN组和对照组(P<0.05),CIN组血清PD-L1水平高于对照组,两组血清SCC-Ag、Tim-4水平比较差异无统计学意义(P>0.05);血清SCC-Ag、Tim-4、PD-L1水平与临床分期、病理分级、浸润深度、淋巴结转移及脉管浸润相关(P<0.05);与年龄、病理类型和肿瘤直径无关(P>0.05);COX回归分析显示,临床分期[OR=1.508,95%CI(1.192,1.908)]、病理分级[OR=1.490,95%CI(1.185,1.874)]、浸润深度[OR=1.464,95%CI(1.182,1.812)]、淋巴结转移[OR=1.514,95%CI(1.204,1.905)]、SCC-Ag[OR=1.501,95%CI(1.203,1.873)]、Tim-4[OR=1.496,95%CI(1.218,1.838)]及PD-L1[OR=1.508,95%CI(1.211,1.879)]为宫颈癌患者预后不良的独立危险因素(P<0.05).结论宫颈癌患者血清SCC-Ag、Tim-4、PD-L1水平明显升高,是患者预后不良的危险因素.

Objective To analyze the correlation between serum squamous cell carcinoma antigen(SCC-Ag),secretory T-cell immunoglobulin and mucin-domain-containing molecule 4(Tim-4),soluble programmed cell death 1(PD-L1)and prognosis in patients with cervical cancer.Methods 60 patients with cervical cancer admitted to our hospital from Jan 2012 to Jan 2015 were selected as cervical cancer group.50 patients with cervical intraepithelial neoplasia(CIN)were selected as CIN group.40 healthy people who completed physical examination in our hospital during the same period were selected as the control group.Serum SCC-Ag,Tim-4 and PD-L1 levels were detected,analyzed the relationship between those and pathological characteristics.Kaplan-Meier method was used to analyze the survival rate of patients with different clinical pathological characteristics.COX regression analysis was performed to analyze the factors affecting the prognosis of cervical cancer patients.Results Serum SCC-Ag,Tim-4 and PD-L1 levels in cervical cancer group were significantly higher than that in CIN group and control group(P<0.05).Serum PD-L1 level in CIN group was higher than that in the control group,but there was no statistically significant difference in serum SCC-Ag or Tim-4 level between the two groups(P>0.05).Serum SCC-Ag,Tim-4 and PD-L1 levels were related to clinical stage,pathological grade,depth of invasion,lymph node metastasis and vascular invasion(P<0.05),but was not related to age,pathological type or tumor diameter(P>0.05).COX regression analysis showed that clinical stage[OR=1.508,95%CI(1.192,1.908)],pathological grade[OR=1.490,95%CI(1.185,1.874)],depth of infiltration[OR=1.464,95%CI(1.182,1.812)],lymph node metastasis[OR=1.514,95%CI(1.204,1.905)],positive expression of SCC-Ag[OR=1.501,95%CI(1.203,1.873)],Tim-4[OR=1.496,95%CI(1.218,1.838)]and PD-L1[OR=1.508,95%CI(1.211,1.879)]were independent risk factors of poor prognosis of cervical cancer patients(P<0.05).Conclusion Serum SCC-Ag,Tim-4 and PD-L1 levels in patients with cervical cancer significantly increased,which are risk factors of poor prognosis of patients with cervical cancer.