胃癌组织中NF-κB、PD-1、PD-L1的表达及其临床意义

Expressions of NF-κB,PD-1,and PD-L1 in gastric cancer and their clinical significance

目的探讨胃癌组织中核转录因子-κB(nuclear factor kappa B,NF-κB)、程序性细胞死亡蛋白-1(programmed cell death protein-1,PD-1)、程序性细胞死亡蛋白配体-1(programmed cell death protein ligand 1,PD-L1)的表达及其临床意义。方法选择2021年1月至2023年12月于南阳市第一人民医院治疗的62例胃癌患者手术切除后组织标本及癌旁正常组织标本分别作为胃癌组及癌旁组。62例患者中,男39例,女23例,年龄(61.86±2.31)岁,肿瘤长径(4.92±0.53)cm。采用免疫组织化学染色法检测NF-κB、PD-1、PD-L1表达情况。比较两组NF-κB、PD-1、PD-L1表达阳性率,分析其与胃癌临床病理特征的关系。采用χ^(2)检验。结果胃癌组NF-κB、PD-1、PD-L1表达阳性率高于癌旁组[83.87%(52/62)比33.87%(21/62)、75.81%(47/62)比30.65%(19/62)、80.65%(50/62)比40.32%(25/62)],差异均有统计学意义(χ^(2)=32.008、25.396、21.088,均P<0.05);肌层及浆膜层浸润、有淋巴结转移及Ⅲ+Ⅳ期患者NF-κB表达阳性率高于黏膜及黏膜下层浸润、无淋巴结转移及Ⅰ+Ⅱ期患者[92.68%(38/41)比66.67%(14/21)、94.74(36/38)比66.67%(16/24)、92.31%(36/39)比69.57%(16/23)],差异均有统计学意义(χ^(2)=5.158、6.619、3.978,均P<0.05);肌层及浆膜层浸润、有淋巴结转移及Ⅲ+Ⅳ期患者PD-1表达阳性率高于黏膜及黏膜下层浸润、无淋巴结转移及Ⅰ+Ⅱ期患者[85.37%(35/41)比57.14%(14/21)、89.47%(34/38)比54.17%(13/24)、89.74%(35/39)比52.17%(12/23)],差异均有统计学意义(χ^(2)=6.031、9.998、11.135,均P<0.05);低分化、肌层及浆膜层浸润、有淋巴结转移及Ⅲ+Ⅳ期患者PD-L1表达阳性率高于高中分化、黏膜及黏膜下层浸润、无淋巴结转移及Ⅰ+Ⅱ期患者[96.00%(24/25)比70.27%(26/37)、90.24%(37/41)比61.90%(13/21)、92.11%(35/38)比62.50%(15/24)、94.87%(37/39)比56.52%(13/23)],差异均有统计学意义(χ^(2)=4.787、5.445、6.472、11.286,均P<0.05)。结论胃癌组织中NF-κB、PD-1、PD-L1表达阳性率升高,且NF-κB、PD-1表达与胃癌浸润深度、淋巴结转移及TNM分期有关,PD-L1表达与胃癌分化程度、浸润深度、淋巴结转移及TNM分期有关。

Objective To explore the expressions of nuclear factor kappa B(NF-κB),programmed cell death protein-1(PD-1),and programmed cell death protein ligand 1(PD-L1)in gastric cancer and their clinical significance.Methods The specimens of the cancer tissue and paracancer tissue of 62 patients with gastric cancer treated in Nanyang First People's Hospital from January 2021 to December 2023 were selected as a gastric cancer group and a paracancer group.Among the 62 patients,there were 39 males and 23 females;they were(61.86±2.31)years old;the biggest tumor diameter was(4.92±0.53)cm.The expressions of NFκB,PD-1,and PD-L1 were detected by immunohistochemical staining;their positive expression rates were compared between the two groups;their relationship with clinicopathological features was analyzed.χ^(2) test was used.Results The positive expression rates of NF-κB,PD-1,and PD-L1 in the gastric cancer group were higher than those in the paracancer group[83.87%(52/62)vs.33.87%(21/62),75.81%(47/62)vs.30.65%(19/62),and 80.65%(50/62)vs.40.32%(25/62)],with statistical differences(χ^(2)=32.008,25.396,and 21.088;all P<0.05).The positive expression rates of NF-κB in the patients with muscle and serosal infiltration,lymph node metastasis,and stageⅢ+Ⅳwere higher than those in the patients with mucosa and submucosa infiltration,no lymph node metastasis,and stageⅠ+Ⅱ[92.68%(38/41)vs.66.67%(14/21),94.74(36/38)vs.66.67%(16/24),and 92.31%(36/39)vs.69.57%(16/23)],with statistical differences(χ^(2)=5.158,6.619,and 3.978;all P<0.05).The positive expression rates of PD-1 in the patients with muscle and serosal infiltration,lymph node metastasis,and stageⅢ+Ⅳwere higher than those in the patients with mucosa and submucosa infiltration,no lymph node metastasis,and stageⅠ+Ⅱ[85.37%(35/41)vs.57.14%(14/21),89.47%(34/38)vs.54.17%(13/24),and 89.74%(35/39)vs.52.17%(12/23)],with statistical differences(χ^(2)=6.031,9.998,and 11.135;all P<0.05).The positive expression rates of PD-L1 in the patients with low differentiation,muscle and serosal infiltration,lymph node metastasis,and stageⅢ+Ⅳwere higher than those in the patients with high differentiation,mucosa and submucosa infiltration,no lymph node metastasis,and stageⅠ+Ⅱ[96.00%(24/25)vs.70.27%(26/37),90.24%(37/41)vs.61.90%(13/21),92.11%(35/38)vs.62.50%(15/24),and 94.87%(37/39)vs.56.52%(13/23)],with statistical differences(χ^(2)=4.787,5.445,6.472,and 11.286;all P<0.05).Conclusions The positive expressions of NF-κB,PD-1,and PD-L1 in gastric cancer are increased.The expressions of NF-κB and PD-1 are related to the depth of gastric cancer invasion,lymph node metastasis,and TNM stage.The expression of PD-L1 is related to the degree of differentiation,depth of invasion,lymph node metastasis,and TNM stage of gastric cancer.