PD-L1在幽门螺杆菌胃炎不同阶段的表达及意义

Expression and significance of programmed death ligand 1 in different stages of Helicobacter pylori gastritis

目的旨在深入了解程序化细胞死亡配体-1(PD-L1)在幽门螺杆菌(Hp)胃炎不同阶段的表达及意义。方法依据纳入标准及排除标准,选择2019年4月至2020年1月在昆明医科大学第一附属医院接受胃镜检查的12例患者,参照《京都胃炎分类》及《中国慢性胃炎共识意见(2017年,上海)》的标准,在胃镜下钳取胃窦部组织送病理检查,并行^(14)C尿素呼气试验。依据活体组织病理检查、Hp特殊染色法及^(14)C尿素呼气试验的结果,将患者分为Hp阴性非萎缩性胃炎组即正常组(A组)、Hp阳性非萎缩性胃炎组(B组)、Hp阳性萎缩性胃炎组(C组)、Hp阳性萎缩性胃炎伴肠化生组(D组),每组3例,采用免疫组织化学染色法、蛋白质印迹法(Western blotting)检测各组胃窦部组织中PD-L1的表达情况。结果Western blotting结果显示,B组、C组、D组的胃黏膜活体组织中PD-L1蛋白表达水平均明显高于A组,差异均有统计学意义(P均<0.0001);C组的PD-L1蛋白表达水平明显高于B组,差异有统计学意义(P<0.01);D组与C组的PD-L1蛋白表达水平差异无统计学意义(P>0.05)。免疫组织化学染色结果显示,A组未见明显的PD-L1阳性表达细胞,B、C、D组均有明显的PD-L1阳性表达细胞,且阳性表达细胞数量均较A组明显增多。结论Hp感染可明显上调胃黏膜组织中PD-L1的表达水平,且PD-L1的表达随着Hp胃炎的进展逐渐呈现出升高趋势。

Objective This paper aims to gain a deeper understanding of the expression and significance of programmed death ligand 1(PD-L1)in different stages of Helicobacter pylori(Hp)gastritis.Methods According to the inclusion criteria and exclusion criteria,twelve patients who underwent gastroscopy in the First Affiliated Hospital of Kunming Medical University from April 2019 to January 2020 were selected.According to《Kyoto classification of gastritis》and《Consensus opinions on chronic gastritis in China(2017,Shanghai)》standard,the gastric antrum tissue was obtained under a gastroscope for pathological examination,and the ^(14)C urea breath test was detected.According to the results of biopsy,Hp special staining and ^(14)C urea breath test,the patients were assigned to the Hp-negative non-atrophic gastritis group(Group A),the Hp-positive non-atrophic gastritis group(Group B),the Hp-positive atrophic gastritis group(Group C),and the Hp-positive atrophic gastritis with intestinal metaplasia group(Group D),3 cases in each group.Immunohistochemical staining and Western blotting were used to detect the expression of PD-L1 in gastric antrum tissues in each group.Results The Western blotting results show that the PD-L1 protein expression in gastric mucosal tissues of Groups B,C,and D is significantly higher than that of Group A,with statistically significant differences(all P<0.0001).The expression level of PD-L1 protein in Group C is significantly higher than that in Group B,with a statistically significant difference(P<0.01).There is no statistically significant difference in PD-L1 protein expression between Group D and Group C(P>0.05).The results of immunohistochemical staining indicate that there are no obvious PD-L1 positive expressing cells in Group A,and there are obvious PD-L1 positive expressing cells in Groups B,C,and D,and the number of positive expressing cells is significantly higher than that in Group A.Conclusion Hp infection can significantly up-regulate the expression level of PD-L1 in gastric mucosal tissue,and the expression of PD-L1 gradually shows an upward trend with the progress of Hp gastritis.