PD-1在原发性肝细胞癌组织中的表达及意义

Expression and significance of programmed death receptor-1 in peripheral blood of patients with primary hepatocellular carcinoma

目的旨在探讨程序性死亡受体-1(PD-1)在原发性肝细胞癌(HCC)组织中的表达及意义。方法回顾性分析2020年5月—2022年5月于联勤保障部队第980(白求恩国际和平)医院接受诊治的HCC患者70例,所有患者均经过影像学及病理学证实为HCC。术中取肝癌原发病灶处癌组织制作为肝癌标本,取肝癌原发病灶5 cm以外的肝组织作为癌旁正常肝组织标本,对所有标本进行切片处理,通过免疫组化、Western blotting等方法,检测标本组织中PD-1的表达情况;分析癌组织、癌旁组织以及不同分化程度的HCC PD-1的表达情况;分析不同病理特征(年龄、性别、肿瘤大小、HBV阳性与否、是否转移、是否合并腹水)对PD-1表达情况的影响。结果癌组织的PD-1表达水平明显高于癌旁组织,差异均具有统计学意义(P<0.05);中分化型HCC PD-1表达水平明显高于高分化及低分化型HCC,差异均具有统计学意义(P<0.05);高分化型与低分化型相比,差异不具有统计学意义(P>0.05);PD-1阳性表达与HCC患者年龄、性别、HBV是否阳性无关,差异不具有统计学意义(P>0.05);PD-1阳性表达与肿瘤大小、肿瘤是否转移以及有无腹水有关,差异具有统计学意义(P<0.05);肿瘤直径>6 cm、肿瘤发生转移以及合并腹水的HCC患者PD-1阳性表达率较高。另外,通过qPCR及Western blotting测定发现PD-1在Ⅲ~Ⅳ期肝癌表达高于Ⅰ~Ⅱ期肝癌。结论PD-1在癌组织中以及中分化型HCC表达水平较高;且肿瘤分期越高,直径越大,合并转移及腹水时,PD-1表达水平高。因此PD-1有望成为判断HCC分期以及预后的指标之一,为HCC的诊断及治疗提供新策略。

Objective To investigate the expression and significance of programmed death receptor-1 in primary hepatocellular carcinoma.Methods A retrospective analysis was performed on 70 patients with HCC treated at the 980th(Baiqiu′en International Peace)Hospital of the Joint Security Force from May 2020 to May 2022.All specimens were sectioned,and the expression of PD-1 in the specimens was measured by immunohistochemistry and Western blotting;The expression of PD-1 in cancer tissues,paraneoplastic tissues and HCC with different degrees of differentiation was analyzed;The influence of different pathological characteristics(age,gender,TNM stage,tumor size,HBV positivity,metastasis or not,combined with ascites or not)on the expression of PD-1 was analyzed.Results PD-1 expression level in cancer tissues was significantly higher than that in paraneoplastic tissues,and the differences were all statistically significant(P<0.05);PD-1 expression level in moderately differentiated HCC was significantly higher than that in highly differentiated and hypodifferentiated HCC,and the differences were all statistically significant(P<0.05);The differences were not statistically significant(P>0.05)when comparing the highly differentiated type with the hypodifferentiated type;PD-1 positive The difference was not statistically significant(P>0.05);PD-1 positive expression was related to TNM stage,tumor size,whether the tumor was metastatic or not,and the presence of ascites(P<0.05);and patients with TNM stage III-IV,tumor diameter>6 cm,tumor metastasis and combined ascites The PD-1 positive expression rate was higher in HCC patients with TNM stage III-IV,tumor diameter>6 cm,metastasis and combined ascites.In addition,PD-1 expression was found to be higher in stage III-IV hepatocellular carcinoma than in stage I-II hepatocellular carcinoma as determined by qPCR and Western blotting.Conclusion PD-1 was expressed at a higher level in cancer tissues and in moderately differentiated HCC;And the higher the tumour stage,the larger the diameter,the combination of metastasis and ascites,the higher the level of PD-1 expression.Therefore,PD-1 is expected to be one of the indicators to determine the stage and prognosis of HCC,providing new strategies for the diagnosis and treatment of HCC.