程序性死亡配体-1和缺氧诱导因子-1α表达与胃癌病人临床病理特征及预后的关系

Relationship between the expression of programmed death ligand 1,hypoxia inducible factor-1αand clinical pathological characteristics,prognosis of gastric cancer patients

目的探讨程序性死亡配体-1(PD-L1)和缺氧诱导因子-1α(HIF-1α)表达与胃癌病人临床病理特征及预后的关系。方法2019年7月~2020年7月行胃癌根治术治疗的胃癌病人100例,取病人癌组织标本并选取其癌旁组织(距离癌组织≥5 cm处的正常组织)作为对照组。采用免疫组化SP法检测PD-L1、HIF-1α的表达。采用Spearman相关性分析分析胃癌组织中PD-L1和HIF-1α的相关性;采用Kaplan-Meier法进行胃癌病人3年生存关系分析;采用单因素、多因素Cox回归分析胃癌病人预后死亡的影响因素。结果100例胃癌病人中,PD-L1阳性表达52例,阴性表达48例;HIF-1α阳性表达67例,阴性表达33例,PD-L1和HIF-1α在胃癌组织中的阳性表达率分别为52.00%、67.00%,高于癌旁组织(11.00%、18.00%),差异有统计学意义(P<0.05)。Spearman相关性分析结果显示,胃癌组织中的PD-L1和HIF-1α表达呈正相关(r=0.730,P<0.001)。胃癌病人PD-L1和HIF-1α的表达与TNM分期、淋巴结有无转移、局部有无浸润有关(P<0.05)。胃癌病人术后3年总生存率为48.00%,PD-L1、HIF-1α阳性表达病人3年生存率为28.85%、31.34%,均低于PD-L1、HIF-1α阴性表达病人(68.75%、81.82%)(Log rankχ2=25.155,P<0.001,Log rankχ2=24.552,P<0.001);且PD-L1、HIF-1α阳性表达、TNM分期为Ⅲ~Ⅳ期、淋巴结转移和局部浸润均为胃癌病人不良预后的独立危险因素(P<0.05)。结论胃癌病人癌组织中PD-L1和HIF-1α均高表达,二者呈正相关,并与病人TNM分期、淋巴结转移等临床病理特征及不良预后有关。

Objective To investigate the relationship between the expression of programmed death ligand 1(PD-L1)and hypoxia inducible factor-1α(HIF-1α)with the clinical pathological characteristics and prognosis of gastric cancer patients.Methods The cancer tissues of 100 gastric cancer patients who underwent radical gastrectomy at the First Hospital of Handan City from July 2019 to July 2020 were selected as the research subjects,and their adjacent tissues(normal tissues≥5 cm from the cancer tissues)were as the control group.Immunohistochemical detection of PD-L1 and HIF-1αwas performed by SP method.Spearman correlation analysis was used to analyze PD-L1 and HIF-1αin gastric cancer tissues.Kaplan-Meier method was used to analyze the 3-year survival relationship of gastric cancer patients.The influencing factors of prognosis and death in patients with gastric cancer were analyzed by univariate and multivariate Cox regression.Results Among 100 gastric cancer patients,52 were PD-L1 positive and 48 were negative;67 were HIF-1αpositive and 33 were HIF-1αnegative,the positive expression rates of PD-L1 and HIF-1αin gastric cancer tissues were 52.00%and 67.00%,respectively,which were obviously higher than those in adjacent tissues(11.00%、18.00%),the difference was statistically significant(P<0.05).Spearman correlation analysis showed that the expression of PD-L1 was positively correlated with that of HIF-1αin gastric cancer tissues(r=0.730,P<0.001).The expressions of PD-L1 and HIF-1αin patients with gastric cancer were correlated with TNM stage,lymph node metastasis and local invasion(P<0.05).The 3-year overall survival rate of gastric cancer patients was 48.00%after surgery,and the 3-years survival rate of patients with positive expression of PD-L1 and HIF-1αwere 28.85%and 31.34%,which were lower than those of patients with negative expression of PD-L1 and HIF-1α(68.75%and 81.82%)(Log rankχ2=25.155,P<0.001.Log rankχ2=24.552,P<0.001).Moreover,positive expression of PD-L1 and HIF-1α,TNM staging ofⅢ-Ⅳ,lymph node metastasis,and local infiltration were independent risk factors for prognosis and death in gastric cancer patients(P<0.05).Conclusion Both PD-L1 and HIF-1αare highly expressed in cancer tissues of gastric cancer patients,and they are positively correlated.They are also associated with clinical pathological features such as TNM staging,lymph node metastasis,and poor prognosis.