本文選題：食管鱗狀細(xì)胞癌 + PD-L1��； 參考：《寧夏醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的檢測PD-L1分子在胸段食管鱗狀細(xì)胞癌(ESCC)患者癌標(biāo)本、癌旁標(biāo)本中的表達(dá)情況,分析癌組織PD-L1表達(dá)情況與胸段ESCC患者的一般臨床病理特征以及生存的關(guān)系,從而探討PD-L1分子是否可以作為判斷胸段ESCC患者預(yù)后的獨(dú)立預(yù)測指標(biāo)。材料與方法2007年1月至2011年7月我院腫瘤外科共收住食管癌患者369例,收集其一般臨床病理資料,經(jīng)納入標(biāo)準(zhǔn)、排除標(biāo)準(zhǔn)刪除部分患者后,對(duì)198例胸段ESCC患者進(jìn)行了隨訪,從104例隨訪資料完整的患者中隨機(jī)選取50名患者作為研究對(duì)象,調(diào)取石蠟標(biāo)本,再從這50名患者中隨機(jī)調(diào)取10例患者的癌旁石蠟標(biāo)本作為對(duì)照組織,進(jìn)行免疫組化檢測PD-L1的表達(dá)情況。結(jié)果50例胸段ESCC患者中27例PD-L1表達(dá)呈陽性(54%),23例表達(dá)呈陰性(46%),10例癌旁組織中1例PD-L1弱陽性表達(dá)(10%)。分析比較癌組織PD-L1表達(dá)情況與患者的臨床病理特征(性別、年齡、民族、飲酒史、吸煙史、身高體重指數(shù)、伴隨的基礎(chǔ)疾病(高血壓、糖尿病、冠心病)、淋巴結(jié)清掃數(shù)目、腫瘤位置、腫瘤大小、手術(shù)吻合方式、組織分化程度、浸潤深度、淋巴結(jié)狀態(tài)、術(shù)后病理分期、術(shù)后輔助治療(放化療))均無顯著性差異(P0.05)。PD-L1陽性表達(dá)組患者5年生存率為22.2%(6/27),陰性表達(dá)組患者5年生存率為47.8%(11/23),比較5年生存率,結(jié)果顯示PD-L1表達(dá)陽性組與陰性組患者的5年生存期有顯著性差異(P0.05),PD-L1陽性表達(dá)組患者的5年生存率明顯低于PD-L1陰性表達(dá)組患者。單因素分析發(fā)現(xiàn)腫瘤浸潤深度(T1/T2 vs T3/T4)、淋巴結(jié)狀態(tài)、術(shù)后病理分期(Ⅰ/Ⅱ期vsⅢ期)、PD-L1表達(dá)情況(PD-L1陽性vs PD-L1陰性)具有顯著統(tǒng)計(jì)學(xué)差異(P0.05)。多因素分析顯示PD-L1表達(dá)情況是胸段ESCC患者預(yù)后的獨(dú)立危險(xiǎn)因素(HR=2.845,95%CI:1.300 6.226,P=0.009)。結(jié)論1.PD-L1在胸段ESCC患者的癌組織中高表達(dá),癌旁組織低表達(dá)。2.PD-L1表達(dá)情況與胸段ESCC患者的一般臨床病理特征無相關(guān)性;腫瘤浸潤深度、淋巴結(jié)狀態(tài)、術(shù)后病理分期、PD-L1表達(dá)情況是胸段ESCC患者預(yù)后的重要影響因素;PD-L1過表達(dá)與較差的預(yù)后相關(guān),PD-L1是胸段ESCC患者不良預(yù)后的獨(dú)立預(yù)測指標(biāo)。
[Abstract]:Objective to detect the expression of PD-L1 molecules in and around the carcinoma of thoracic esophageal squamous cell carcinoma (ESCC), and to analyze the relationship between the expression of PD-L1 and the general clinicopathological features and survival of ESCC patients with thoracic esophageal squamous cell carcinoma (ESCC). To explore whether PD-L1 molecule can be used as an independent predictor of prognosis in patients with thoracic ESCC. Materials and methods from January 2007 to July 2011, 369 patients with esophageal cancer were enrolled in our hospital. The general clinical and pathological data were collected. 198 cases of thoracic ESCC were followed up after inclusion of the criteria and exclusion of some patients. Paraffin wax samples were collected randomly from 104 patients with complete follow-up data, and 10 paraffin specimens from these 50 patients were randomly selected as control tissue. The expression of PD-L1 was detected by immunohistochemistry. Results the expression of PD-L1 was positive in 27 out of 50 cases of thoracic ESCC. The expression of PD-L1 was negative in 23 cases. The expression of PD-L1 was weak in 1 case of 10 paracancerous tissues. The expression of PD-L1 was compared with the clinicopathological features (sex, age, nationality, alcohol consumption, smoking history, body mass index, accompanied diseases (hypertension, diabetes, coronary heart disease, lymph node dissection). Tumor location, tumor size, surgical anastomosis, degree of tissue differentiation, depth of invasion, lymph node status, postoperative pathological stages, There was no significant difference in postoperative adjuvant therapy (radiotherapy and chemotherapy). The 5-year survival rate of patients with positive expression of P0.05N. PD-L1 was 22. 2 / 27. The 5-year survival rate of patients with negative expression was 47.811 / 23. The 5-year survival rate was higher than that of patients with positive expression of PD-L1. The results showed that the 5-year survival rate of PD-L1 positive expression group was significantly lower than that of PD-L1 negative expression group, and the 5-year survival rate of PD-L1 positive expression group was significantly lower than that of PD-L1 negative expression group. Univariate analysis showed that there were significant differences in tumor invasion depth (T 1 / T 2 vs T 3 / T 4), lymph node status, postoperative pathological stage (stage 鈪，

本文編號(hào)：2044042