本文選題：PD-L1 + 食管癌�。� 參考：《浙江大學(xué)》2017年碩士論文

【摘要】：目的:檢測(cè)程序性死亡分子配體-1(programmed death ligand-1,PD-L1)在術(shù)后食管鱗癌中的表達(dá),評(píng)估其在指導(dǎo)食管鱗癌臨床治療中的預(yù)后價(jià)值,探索其是否能夠指導(dǎo)食管鱗癌免疫治療的臨床應(yīng)用。方法:采用單中心回顧性研究方法,選擇2014年6月1日至2016年6月1日于浙江大學(xué)醫(yī)學(xué)院附屬醫(yī)院行食管癌根治術(shù)的患者,篩選出術(shù)后有隨訪及繼續(xù)治療的45例食管鱗癌患者。對(duì)45例患者術(shù)后的食管癌病理標(biāo)本進(jìn)行切片,采用免疫組化的方法檢測(cè)病理切片中PD-L1的表達(dá)。根據(jù)免疫組化的結(jié)果將病人分為PD-L1陽(yáng)性組和陰性組,采用卡方檢驗(yàn)評(píng)估PD-L1的表達(dá)和患者臨床特征及病理因素的關(guān)系,采用對(duì)數(shù)秩檢驗(yàn)確定不同臨床病理特征患者的生存差異。結(jié)果:PD-L1表達(dá)陽(yáng)性的患者皆為男性,有吸煙史、飲酒史,有淋巴結(jié)轉(zhuǎn)移。但經(jīng)統(tǒng)計(jì)分析,PD-L1的表達(dá)與年齡、性別、吸煙史、飲酒史、大體類型、淋巴結(jié)轉(zhuǎn)移、分化程度、病理分期差異無(wú)統(tǒng)計(jì)學(xué)意義,P值分別為0.517,0.696,0.286,0.503,0.641,0.206,0.401,0.788。PD-L1表達(dá)陽(yáng)性組的DFS同PD-L1表達(dá)陰性組的DFS差異無(wú)統(tǒng)計(jì)學(xué)意義,P值為0.551。PD-L1表達(dá)陽(yáng)性組的OS同PD-L1表達(dá)陰性組的OS差異無(wú)統(tǒng)計(jì)學(xué)意義,P值為0.854。結(jié)論:PD-L1在術(shù)后食管鱗癌中的表達(dá)與患者的性別、年齡、吸煙史、飲酒史、大體類型、分化程度、淋巴結(jié)轉(zhuǎn)移、病理分期無(wú)關(guān)。不管是單因素還是多因素分析,PD-L1的表達(dá)與總生存期、無(wú)病生存期都無(wú)關(guān)。
[Abstract]:Objective: to detect the expression of programmed death molecular ligand (-1C) -programmed death ligand PD-L1) in postoperative esophageal squamous cell carcinoma, to evaluate its prognostic value in guiding the clinical treatment of esophageal squamous cell carcinoma, and to explore whether it can guide the clinical application of immunotherapy for esophageal squamous cell carcinoma.Methods: a single center retrospective study was used to select 45 patients with esophageal squamous cell carcinoma who underwent radical esophagectomy from June 1, 2014 to June 1, 2016 in the affiliated Hospital of Zhejiang University Medical College.The expression of PD-L1 in 45 patients with esophageal carcinoma was detected by immunohistochemical method.According to the results of immunohistochemistry, the patients were divided into PD-L1 positive group and negative group. Chi-square test was used to evaluate the relationship between the expression of PD-L1 and clinical features and pathological factors, and logarithmic rank test was used to determine the survival difference of patients with different clinicopathological characteristics.Results all of the patients with positive expression of w-PD-L1 were male. They had a history of smoking, drinking, and lymph node metastasis.But the expression of PD-L1 was correlated with age, sex, smoking history, drinking history, gross type, lymph node metastasis and differentiation.There was no significant difference in pathological staging (P = 0.517) 0.696U 0.286U 0.503n 0.641C 0.206U 0.401U 0.788.There was no significant difference in DFS between DFS and PD-L1 negative group. There was no significant difference in P value between OS and PD-L1 expression group (P = 0.854).Conclusion the expression of the weight PD-L1 in postoperative esophageal squamous cell carcinoma is not related to sex, age, smoking history, drinking history, gross type, differentiation degree, lymph node metastasis and pathological stage.Neither univariate nor multivariate analysis showed that the expression of PD-L1 was not related to total survival and disease-free survival.
【學(xué)位授予單位】：浙江大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R735.1

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