早期胃癌肿瘤浸润深度与癌组织PD-L1、Arg-1表达的关系

Relationship between the depth of tumor invasion and the expression of PD-L1 and Arg-1 in early gastric cancer

目的 探讨早期胃癌肿瘤浸润深度与癌组织程序性死亡配体-1(PD-L1)、精氨酸酶-1(Arg-1)表达的关系。方法 回顾性选取2020年1月至2022年1月在琼海市人民医院治疗的早期胃癌患者110例,采用免疫组织化学染色法检测胃癌组织和癌旁组织的PD-L1、Arg-1表达,内镜检查早期胃癌浸润深度情况,分析早期胃癌浸润深度的影响因素。结果 早期胃癌组织PD-L1和Arg-1阳性表达率分别为58.18%和76.36%,均明显高于癌旁组织(22.73%、30.91%),差异均有统计学意义(P<0.05)。合并溃疡、病变边缘有隆起、PD-L1阳性表达、Arg-1阳性表达组织黏膜下层深浸润比例分别为54.35%、51.16%、43.75%和39.29%,明显高于未合并溃疡、病变边缘无隆起、PD-L1阴性表达、Arg-1阴性表达组织(15.63%、19.40%、15.22%和7.69%),差异均有统计学意义(P<0.05)。肿瘤大小>1 cm、未分化型组织PD-L1阳性表达率分别为73.33%和97.67%,Arg-1阳性表达率分别为95.56%和93.02%,明显高于肿瘤大小≤1 cm(47.69%、63.08%)、分化型组织(32.84%、65.67%),差异均有统计学意义(P<0.05)。Logistic回归分析显示合并溃疡、病变边缘隆起、PD-L1和Arg-1表达是黏膜下层深浸润的影响因素(OR=2.779,95%CI:1.540~5.013;OR=2.596,95%CI:1.667~4.043;OR=1.976,95%CI:1.378~2.834;OR=1.749,95%CI:1.321~2.315;P<0.05)。结论 早期胃癌肿瘤组织PD-L1、Arg-1表达上调,与肿瘤大小及组织分化有关,同时PD-L1、Arg-1表达是肿瘤浸润深度的影响因素。

Objective To investigate the relationship between the depth of tumor invasion and the expression of programmed death ligand-1(PD-L1) and arginase-1(Arg-1) in early gastric cancer. Methods A total of 110 patients with early gastric cancer treated in Qionghai People’s Hospital from January 2020 to January 2022 were retrospectively selected, the expressions of PD-L1 and Arg-1 in gastric cancer tissues and adjacent tissues were detected by immunohistochemical staining, the depth of invasion of early gastric cancer was examined by endoscopy, and the influencing factors of the depth of invasion of early gastric cancer were analyzed. Results The positive expression rates of PD-L1 and Arg-1 in early gastric cancer were 58.18% and 76.36% respectively, which were significantly higher than those in adjacent tissues(22.73%, 30.91%), the differences were statistically significant(P<0.05). The deep infiltration rates of submucosa in the tissues with ulcer, bulge at the edge of the lesion, PD-L1 positive expression and Arg-1 positive expression were 54.35%, 51.16%, 43.75% and 39.29% respectively, which was significantly higher than that of tissues without ulcer, no uplift at the edge of the lesion, PD-L1 negative expression and Arg-1 negative expression(15.63%, 19.40%, 15.22% and 7.69%), the differences were statistically significant(P<0.05). The positive expression rates of PD-L1 and Arg-1 in tumor size >1 cm and undifferentiated tissues were 73.33% and 97.67%, 95.56% and 93.02% respectively, which were significantly higher than those in tumor size ≤1 cm(47.69%, 63.08%), and differentiated tissues(32.84%, 65.67%), the differences were statistically significant(P<0.05). Logistic regression analysis showed that the factors influencing deep infiltration of submucosa were complicated with ulcer, swelling of lesion margin, expression of PD-L1 and Arg-1(OR=2.779, 95%CI:1.540-5.013;OR=2.596, 95%CI:1.667-4.043;OR=1.976, 95%CI:1.378-2.834;OR=1.749, 95%CI:1.321-2.315;P<0.05). Conclusion The expression of PD-L1 and Arg-1 in early gastric cancer is up-regulated, which is related to tumor size and tissue differentiation. At the same time, the expression of PD-L1 and Arg-1 is the influencing factor of tumor invasion depth.