外周血sCTLA-4、sPD-L1及Ki-67在晚期卵巢癌中表达水平及与预后的相关性分析

Expression levels of peripheral blood sCTLA-4,sPD-L1 and Ki-67 in advanced ovarian cancer and their correlation with prognosis

目的探讨晚期卵巢癌(Ⅲc期和Ⅳ期)患者外周血可溶性细胞毒性T淋巴细胞相关抗原4(sCTLA-4)、可溶性程序性死亡配体-1(sPD-L1)、Ki-67的表达水平以及与其预后的相关性分析。方法采用前瞻性研究,选取2019年1月至2020年1月于空军军医大学第一附属医院就诊的88例晚期卵巢癌患者纳入观察组,92例卵巢良性肿瘤患者纳入对照组。检测并比较两组患者外周血sCTLA-4、sPD-L1、Ki-67的表达水平,分析外周血sCTLA-4、sPD-L1、Ki-67表达水平与晚期卵巢癌临床病理特征及患者预后的关系;根据外周血sCTLA-4、sPD-L1水平均数高低及Ki-67阳性细胞率大小将观察组分为高表达组与低表达组,随访2年时间,比较两组患者的预后质量。结果观察组患者外周血sCTLA-4、sPD-L1表达水平为(17.64±5.28)、(14.79±4.36)ng/mL,均明显高于对照组[(9.84±2.68)、(8.16±2.26)ng/mL],差异均有统计学意义(P<0.05)。观察组患者Ki-67表达水平为76.14%,明显高于对照组(30.43%),差异有统计学意义(P<0.05)。外周血sCTLA-4、sPD-L1及Ki-67表达水平与观察组卵巢癌患者的分化程度、临床分期、腹水量有关联(P<0.05),与患者的年龄、卵巢癌病理类型、糖链多肽抗原125(CA125)水平无关联(P>0.05)。对观察组患者进行1~2年的随访,共有死亡病例28例。其中sCTLA-4、sPD-L1及Ki-67表达水平的各低表达组的生存率均显著明显高于其高表达组,差异均有统计学意义(P<0.05)。结论外周血sCTLA-4、sPD-L1及Ki-67在晚期卵巢癌中呈高表达水平,与晚期卵巢癌患者的预后生存质量有密切联系。

Objective To investigate the expression levels of soluble cytotoxic T lymphocyte associated antigen 4(sCTLA-4),soluble programmed death ligand-1(sPD-11)and Ki-67 in peripheral blood of patients with advanced ovarian cancer(stageⅢC and stageⅣ).Methods Using prospective studies,a total of 88 patients with advanced ovarian cancer who were treated in the First Affiliated Hospital of Air Force Military Medical University from January 2019 to January 2020 were selected and included in the observation group,and 92 patients with benign ovarian tumors were included in the control group.The expression levels of sCTLA-4,sPD-L1,and Ki-67 in peripheral blood of the two groups of patients were detected and compared.The relationship between clinicopathological characteristics and prognosis of patients with advanced ovarian cancer;the observation group was divided into a high expression group and a low expression group according to the levels of sCTLA-4 and sPD-L1 in peripheral blood and the rate of Ki-67 positive cells,and were followed up for 2 years time,and compared the quality of prognosis of the two groups of patients.Results The expression levels of sCTLA-4 and sPD-L1 of the peripheral blood in the observation group were(17.64±5.28),(14.79±4.36)ng/mL,which were significantly higher than those in the control group[(9.84±2.68),(8.16±2.26)ng/mL],and the differences were statistically significant(P<0.05).The expression level of Ki-67 in the observation group was 76.14%,which was significantly higher than that in the control group group(30.43%),the difference was statistically significant(P<0.05).The expression levels of sCTLA-4,sPD-L1 and Ki-67 in peripheral blood were correlated with the degree of differentiation,clinical stage and ascites volume of ovarian cancer patients in the observation group(P<0.05),and there was no correlation between the age of the patients,the pathological type of ovarian cancer and the level of CA125(P>0.05).The patients in the observation group were followed up for 1 to 2 years,and there were 28 deaths.The survival rates of each low expression group of sCTLA-4,sPD-L1 and Ki-67 expression level were significantly higher than those of its high expression group,the differences were statistically significant(P<0.05).Conclusion Peripheral blood sCTLA-4,sPD-L1 and Ki-67 are highly expressed in advanced ovarian cancer,which are closely related to the prognosis and quality of life of patients with advanced ovarian cancer.