肝癌患者PD-1、PD-L1、CMTM6水平与术后复发风险的相关性

The correlation between the levels of PD-1,PD-L1,and CMTM6 in patients with liver cancer and the risk of postoperative recurrence

目的探讨肝癌患者程序性死亡受体1(PD-1)、程序性死亡配体(PD-L1)、趋化素样因子超家族6(CMTM6)水平与术后复发风险的相关性。方法前瞻性选取2017年6月~2018年6月我院肝癌术后患者102例,随访观察3年,采用Kaplan-Meier绘制复发曲线,并根据复发情况分为复发组和非复发组。收集两组一般资料、肿瘤因素、肝脏功能状态、健康状态及免疫水平(PD-1、PD-L1、CMTM6免疫组织化学染色情况),并采用Logistic回归分析影响肝癌患者术后复发的相关因素。结果随访结束,共3例因各种原因失访,最终纳入99例,Kaplan-Meier曲线累积复发率为35.35%,复发时间(25.80±3.20)月,其中复发组35例非复发组64例;两组肿瘤直径、BCLC分期、PD-L1、PD-1、CMTM6对比差异具有统计学意义(P<0.05);多因素Logistic回归分析显示:PD-1(0R=3.632,95%CI1.393~9.470)、CMTM6(OR=2.496,95%CI1.274~4.890)、肿瘤直径(0R=3.015,95%CI1.039~8.753)、PD-L1(0R=2.803,95%CI1.335~5.885)为肝癌术后复发的危险因素(均P<0.05)。结论PD-1、PD-L1、CMTM6水平在肝癌术后复发过程中发挥着重要作用,这可能成为肝癌治疗的一个新方向。

Objective To explore the correlation between the levels of programmed death receptor 1(PD-1),programmed death ligand(PD-L1),chemokine-like factor superfamily 6(CMTM6)and the risk of postoperative recurrence in patients with liver cancer.Methods Prospectively selected 102 patients after liver cancer surgery in our hospital from June 2017 to June 2018.Followed up for 3 years,Kaplan-Meier was used to draw the recurrence curve,and the recurrence was divided into recurrence group and non-recurrence group.Collected two groups of general information,tumor factors,liver function status,health status and immune level(PD-1,PD-L1,CMTM6 immunohistochemical staining),Used Logistic regression to analyze the related factors that affect the recurrence of liver cancer patients after surgery.ResultsAt the end of the follow-up,a total of 3 cases were lost to follow-up due to various reasons,and 99 cases were finally included.The cumulative recurrence rate of Kaplan-Meier curve was 35.35%,and the recurrence time was(25.80±3.20)months,including 35 cases in the recurrence group and 64 cases in the non-recurrence group;The difference in tumor diameter,BCLC staging,PD-L1,PD-1,CMTM6 between the two groups was statistically significant(P<0.05);Multivariate logistic regression analysis showed:PD-1(OR=3.632,95%CI1.393~9.470,CMTM6(0R=2.496,95%CI1.274~4.890),tumor diameter(OR=3.015,95%CI1.039~8.753),PD-L1(OR=2.803,95%CI1.335~5.885)were risk factors for recurrence of liver cancer after surgery(all P<0.05).Conclusion The levels of PD-1,PD-L1,and CMTM6 play an important role in the recurrence of liver cancer after surgery,which may become a new direction in the treatment of liver cancer.