循环肿瘤细胞上细胞程序性死亡配体1表达对宫颈癌同步放化疗预后的评估价值

Evaluation value of programmed cell death ligand 1 expression on circulating tumor cells for prognosis of cervical cancer after concurrent chemoradiotherapy

目的探讨循环肿瘤细胞(CTC)上细胞程序性死亡配体1(PD-L1)表达对宫颈癌同步放化疗预后的评估价值。方法回顾性选取2021年6月至2023年12月入临汾市人民医院的60例宫颈癌患者,均经病理学确诊,CTC PD-L1经CytoSorter CTC系统测定。对宫颈癌病理特征与PD-L1^(+)CTC之间的相关性予以分析,并比较PD-L1^(+)CTC和PD-L1-CTC宫颈癌患者同步放化疗前后的无进展生存期(PFS),评估宫颈癌放化疗后PD-L1^(+)CTC数量对预后的评估价值。结果同步放化疗前后外周血CTC检出率及数量比较,差异无统计学意义(P>0.05)。较同步放化疗前,宫颈癌患者同步放化疗后PD-L1^(+)CTC检出率更低(38.33%vs.56.67%),PD-L1^(+)CTC检出数量更少[(0.77±1.20)个vs.(1.27±1.51)个],差异均有统计学意义(P<0.05)。同步放化疗前,宫颈癌患者PD-L1^(+)CTC与肿瘤直径、FIGO分期、分化程度及淋巴结转移联系紧密(P<0.05)。同步放化疗后,宫颈癌患者PD-L1^(+)CTC表达水平与肿瘤直径、FIGO分期、分化程度及淋巴结转移密切相关(P<0.05)。PD-L1^(+)CTC患者的PFS短于PD-L1-CTC患者,差异有统计学意义(P<0.05)。Cox回归分析显示,局部晚期宫颈癌患者同步放化疗前后的CTC PD-L1表达水平均可作为PFS预后因素。结论宫颈癌放同步放化疗前后测定的CTC PD-L1表达水平可作为预后评估的辅助指标。

Objective To evaluate the expression of programmed cell death ligand 1(PD-L1)in circulating tumor cell(CTC)in the prognosis of cervical cancer after concurrent chemoradiotherapy.Methods Sixty patients with cervical cancer admitted to Linfen People's Hospital from June 2021 to December 2023 were retrospectively selected.All of them were confirmed by pathology,and CTC PD-L1 was determined by CytoSorter CTC system.The correlation between pathological features of cervical cancer and PD-L1^(+)CTC was analyzed,and the progression-free survival(PFS)of cervical cancer patients with PD-L1^(+)CTC and PD-L1-CTC before and after concurrent chemoradiotherapy was compared,the prognostic value of PD-L1^(+)CTC quantity before and after concurrent chemoradiotherapy of cervical cancer was evaluated.Results There were no statistically significant differences in the detection rate and quantity of peripheral blood CTC before and after synchronous radiotherapy and chemotherapy(P>0.05).Compared with before synchronous radiotherapy and chemotherapy,the detection rate of PD-L1^(+)CTC in cervical cancer patients after synchronous radiotherapy and chemotherapy was lower(38.33%vs.56.67%),and the number of PD-L1^(+)CTC detected was lower[(0.77±1.20)vs.(1.27±1.51)],the differences were statistically significant(P<0.05).Before concurrent chemoradiotherapy,PD-L1^(+)CTC in patients with cervical cancer was closely related to tumor diameter,FIGO stage,differentiation degree and lymph node metastasis(P<0.05).After concurrent chemoradiotherapy,the expression level of PD-L1^(+)CTC in patients with cervical cancer was closely related to tumor diameter,FIGO stage,differentiation degree and lymph node metastasis(P<0.05).The PFS of PD-L1^(+)CTC patients was shorter than that of PD-L1-CTC patients,and the difference was significant(P<0.05).Cox regression analysis showed that the expression level of CTC PD-L1 before and after concurrent radiotherapy and chemotherapy could be used as a prognostic factor for PFS in patients with locally advanced cervical cancer.Conclusion The expression level of CTC PD-L1 measured before and after radiotherapy and chemotherapy can be used as an auxiliary index for prognosis evaluation of cervical cancer.