本文選題：PD-L1 + FOXM1　； 參考：《大連醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:通過(guò)檢測(cè)PD-L1和FOXM1蛋白在非小細(xì)胞肺癌(none small cell lung cancer,NSCLC)組織中的表達(dá)情況,分析其表達(dá)與患者臨床病理參數(shù)和預(yù)后之間的關(guān)系,同時(shí)分析二者表達(dá)是否具有相關(guān)性,進(jìn)一步了解PD-L1表達(dá)水平調(diào)控的機(jī)制,為探索NSCLC免疫治療的療效預(yù)測(cè)提供理論依據(jù)。方法:收集大連醫(yī)科大學(xué)附屬第二醫(yī)院胸外科2014.11-2015.4期間收治的行手術(shù)切除且組織學(xué)證實(shí)為NSCLC的患者石蠟組織標(biāo)本80例,同時(shí)選取癌旁組織20例作為對(duì)照,通過(guò)免疫組化的方法檢測(cè)PD-L1和FOXM1蛋白在組織中的表達(dá)情況,應(yīng)用細(xì)胞染色著色強(qiáng)度與陽(yáng)性細(xì)胞數(shù)量的乘積進(jìn)行評(píng)估。采用SPSS22版對(duì)所有數(shù)據(jù)進(jìn)行統(tǒng)計(jì)學(xué)分析,并用卡方檢驗(yàn)分析PD-L1和FOXM1蛋白表達(dá)與NSCLC患者臨床病理資料特征之間的相關(guān)性,Kaplan-Meier生存曲線、Log-rank檢驗(yàn)進(jìn)行預(yù)后分析,Spearman等級(jí)相關(guān)分析法分析癌組織中兩種蛋白表達(dá)的相關(guān)性。結(jié)果:NSCLC組織中PD-L1表達(dá)定位于細(xì)胞膜和細(xì)胞漿,癌組織中陽(yáng)性表達(dá)率為56.3%(45/80),較癌旁組織30%(6/20)顯著升高(χ2=4.412,P0.05);PD-L1表達(dá)與腫瘤大小(χ2=7.672,P0.05)、淋巴結(jié)轉(zhuǎn)移(χ2=5.261,P0.05)、TNM分期(χ2=11.506,P0.05)、FOXM1表達(dá)(χ2=10.173,P0.05)顯著相關(guān);與性別、年齡、吸煙狀態(tài)、病理類型、分化程度均無(wú)明顯相關(guān)性(P0.05)。FOXM1表達(dá)定位于細(xì)胞核,癌組織中陽(yáng)性表達(dá)率為65%(52/80),較癌旁組織40%(8/20)顯著升高(χ2=4.167,P0.05);FOXM1表達(dá)與腫瘤組織分化程度(χ2=10.741,P0.05)、淋巴結(jié)轉(zhuǎn)移(χ2=7.299,P0.05)、TNM分期(χ2=11.747,P0.05)顯著相關(guān);與性別、年齡、是否吸煙、病理類型、腫瘤大小均無(wú)明顯相關(guān)性(P0.05)。Kaplan-Meier單因素生存分析顯示PD-L1和FOXM1蛋白表達(dá)陽(yáng)性組無(wú)復(fù)發(fā)生存期(RFS)較陰性組顯著降低(log-rank檢驗(yàn)結(jié)果示χ2=4.238,P0.05;χ2=4.368,P0.05),差異具有統(tǒng)計(jì)學(xué)意義,提示與預(yù)后呈負(fù)相關(guān)。PD-L1和FOXM1表達(dá)在總生存(OS)上無(wú)統(tǒng)計(jì)學(xué)差異(P0.05)。Spearman相關(guān)性分析顯示NSCLC組織中PD-L1和FOXM1表達(dá)呈正相關(guān)(R=0.357,P0.01)。結(jié)論:1.PD-L1和FOXM1參與NSCLC的發(fā)生發(fā)展。2.PD-L1和FOXM1在NSCLC的侵襲和轉(zhuǎn)移中發(fā)揮作用。3.PD-L1和FOXM1高表達(dá)是NSCLC患者預(yù)后不良的預(yù)測(cè)因子。4.在NSCLC組織中可能存在FOXM1對(duì)PD-L1的調(diào)控作用。
[Abstract]:Objective: to investigate the expression of PD-L1 and FOXM1 in non-small cell lung cancer (NSCLC), and to analyze the relationship between the expression and clinicopathological parameters and prognosis of NSCLC. To further understand the mechanism of PD-L1 expression level regulation, to explore the efficacy of NSCLC immunotherapy prediction provides theoretical basis. Methods: a total of 80 paraffin tissue specimens were collected from thoracic surgery department of the second affiliated Hospital of Dalian Medical University from April to April 2014,2014.The paraffin tissue specimens were obtained from 80 patients with histologically proved NSCLC, and 20 patients with paracancerous tissue were selected as control group. The expression of PD-L1 and FOXM1 in tissues was detected by immunohistochemical method, and the product of staining intensity and the number of positive cells was used to evaluate the expression. Using the SPSS22 version of all the data for statistical analysis, The correlation between the expression of PD-L1 and FOXM1 protein and the clinicopathological features of NSCLC patients was analyzed by chi-square test. Kaplan-Meier survival curve and Log-rank test were used to analyze the prognostic analysis. Spearman rank correlation analysis was used to analyze the correlation between the expression of the two proteins in cancer tissues. Results the expression of PD-L1 was localized in cell membrane and cytoplasm. The positive expression rate of PD-L1 in cancer tissues was 56.33 / 45 / 80, which was significantly higher than that in adjacent tissues (蠂 24.412 P 0.05 P 0.05 P 0.05 P 0.05) (蠂 2 / 7.672P 0.05 and lymph node metastasis (蠂 ~ 25.261) P 0.05 / 0. 05 TNM stage (蠂 ~ 211.506) (蠂 ~ 210.173P 0.05), and it was associated with sex, age, and lymph node metastasis (蠂 ~ 25.261 ~ (11.506) (蠂 ~ (2) 11.506) (蠂 ~ (210.173) P 0.05), and the expression of PD-L1 was significantly correlated with sex, age, and tumor size. There was no significant correlation among smoking status, pathological type and differentiation degree. The expression of P0.05A. FOXM1 was located in the nucleus. The positive expression rate of FOXM1 in cancer tissues was 65 / 52 / 80, which was significantly higher than that in paracancerous tissues (40 / 20) (蠂 ~ 24.167 / P 0.05). The expression of FOXM1 was significantly correlated with the differentiation of tumor tissues (蠂 ~ 2 / 10.741) and lymph node metastasis (蠂 ~ 2 / 7.299P _ 0.05TNM staging (蠂 ~ 2 / 7.299P _ 0.05TNM) (蠂 ~ 2 / 7.299P _ 0.05T _ 0.05), and was significantly correlated with sex, age, smoking, pathological type, sex, age, smoking and pathological type. There was no significant correlation between tumor size and tumor size. Kaplan-Meier single factor survival analysis showed that PD-L1 and FOXM1 protein expression positive group had significantly lower survival time without recurrence than negative group. The results of 蠂 2 + 4. 238% P 0.05 and 蠂 2 + 4. 368% P 0. 05 were significantly lower than those of negative group, and the difference was statistically significant. It was suggested that there was no significant difference in the expression of PD-L1 and FOXM1 in the total survival of NSCLC. The correlation analysis showed that there was a positive correlation between the expression of PD-L1 and FOXM1 in NSCLC tissues. Conclusion: 1. PD-L1 and FOXM1 are involved in the occurrence and development of NSCLC. 2.PD-L1 and FOXM1 play a role in the invasion and metastasis of NSCLC. 3. The high expression of PD-L1 and FOXM1 is the predictor of poor prognosis in NSCLC patients. The regulation of FOXM1 on PD-L1 may exist in NSCLC tissues.
【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R734.2

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本文編號(hào)：1835230