PD-L1、HIF-1α在三陰乳腺癌中表達的意義及其與中醫(yī)體質(zhì)分類的關聯(lián)性研究
發(fā)布時間：2019-01-22 13:13
【摘要】：目的:1、研究三陰乳腺癌(TNBC)中PD-L1和HIF-1α蛋白的表達及其與臨床病理參數(shù)、生存預后的相關性。探討二者共表達在TNBC中的預后價值;2、調(diào)查TNBC的中醫(yī)體質(zhì)分布特點,分析體質(zhì)與PD-L1、HIF-1α表達及患者生存預后的相關性。方法:1、收集福州總醫(yī)院2010年1月至2013年12月手術病理確診為TNBC的患者103例,收集入組患者的臨床病理資料并隨訪其生存預后情況;2、采用免疫組織化學方法檢測PD-L1和HIF-1α的表達情況;3、運用中華中醫(yī)藥學會的《中醫(yī)體質(zhì)分類與判定表》對患者進行中醫(yī)體質(zhì)辨識和分類;4、采用SPSS 20.0統(tǒng)計軟件對結果進行統(tǒng)計分析。結果:1、TNBC 中 PD-L1 和 HIF-1α的陽性率分別為 30.1%(31/103)和 54.4%(56/103),二者表達呈正相關(r=0.559,P=0.000)。PD-L1表達與腫瘤大小、淋巴結轉(zhuǎn)移、腫瘤分期顯著相關(P=0.004、0.009、0.000);HIF-1α表達與年齡、腫瘤大小、組織學分級、淋巴結轉(zhuǎn)移、腫瘤分期顯著相關(P=0.007、0.000、0.000、0.001、0.000)。Kαplαn-Meier生存曲線和Log-Rαnk分析顯示:腫瘤大小、TNM分期、淋巴結轉(zhuǎn)移情況及腫瘤PD-L1、HIF-1α表達可影響 TNBC 患者的 3 年 DFS(P=0.01、0.000、0.000、0.000、0.000),進一步多因素分析顯示:僅腫瘤PD-L1表達與TNM分期為TNBC患者的獨立預后不良因素(P-0.016、0.002)。2、TNBC中PD-L1和HIF-1α不同的表達組合可影響患者的生存預后,共表達組即雙陽組3年DFS率顯著低于未共表達組即單陽組及雙陰組(P=0.000),三組生存曲線出現(xiàn)明顯分離。3、TNBC體質(zhì)由多到少依次為:氣郁質(zhì)、血瘀質(zhì)、痰濕質(zhì)、濕熱質(zhì)、氣虛質(zhì)和陰虛質(zhì)。各體質(zhì)類型中PD-L1與HIF-1α表達無顯著差異(P=0.892、0.700),各體質(zhì)類型3年DFS無顯著差異(P=0.655)。結論:1、PD-L1和HIF-1α在TNBC中高表達,且二者表達呈正相關。PD-L1和HIF-1α表達均與不良預后相關,但僅PD-L1可作為TNBC患者的獨立預后不良因素。2、PD-L1和HIF-1α共表達患者3年DFS顯著低于未共表達患者,TNBC中二者共表達提示預后不良。3、TNBC人群體質(zhì)均為偏頗體質(zhì),氣郁質(zhì)和血瘀質(zhì)所占比例最大(54.3%)。中醫(yī)體質(zhì)分類與PD-L1/HIF-1α表達無明顯相關,與TNBC患者的生存預后無明顯相關。
[Abstract]:Objective: 1. To study the expression of PD-L1 and HIF-1 偽 protein in (TNBC) and its correlation with clinicopathological parameters and survival prognosis. To explore the prognostic value of co-expression of PD-L1,HIF-1 偽 in TNBC. 2. To investigate the distribution of TCM physique of TNBC, and to analyze the correlation between constitution and PD-L1,HIF-1 偽 expression and survival prognosis of patients. Methods: 1. 103 patients with TNBC were collected from January 2010 to December 2013 in Fuzhou General Hospital. The clinicopathological data of the patients were collected and their survival and prognosis were followed up. (2) the expression of PD-L1 and HIF-1 偽 was detected by immunohistochemical method. 4. The results were analyzed by SPSS 20.0 software. Results: 1the positive rates of PD-L1 and HIF-1 偽 in TNBC were 30.1% (31 / 103) and 54.4% (56 / 103), respectively. The expression of PD-L1 was positively correlated with tumor size and lymph node metastasis. There was a significant correlation between tumor stage and tumor stage (P < 0.004 / 0. 009 / 0. 000). The expression of HIF-1 偽 was significantly correlated with age, tumor size, histological grade, lymph node metastasis and tumor stage (P0. 0070.0000.0000.0000.000). K 偽 pl 偽 n-Meier survival curve and Log-R 偽 nk analysis: tumor size, TNM stage. Lymph node metastasis and tumor PD-L1,HIF-1 偽 expression could affect the DFS of TNBC patients in 3 years. Further multivariate analysis showed that only tumor PD-L1 expression and TNM staging were independent prognostic factors (P-0.016 ~ 0.002). 2different expression combinations of PD-L1 and HIF-1 偽 in TNBC could affect the survival prognosis of TNBC patients. The 3-year DFS rate in the co-expression group (Shuangyang group) was significantly lower than that in the non-co-expression group (single positive group and double-negative group) (P0. 000). Qi deficiency and yin deficiency. There was no significant difference in the expression of PD-L1 and HIF-1 偽 between different physique types (P < 0. 892P 0. 700), but there was no significant difference in 3 years DFS expression among different physique types (P 0. 655). Conclusion: 1 the expression of PD-L1 and HIF-1 偽 in TNBC is highly expressed, and the expression of PD-L1 and HIF-1 偽 is positively correlated with the poor prognosis, but only PD-L1 can be used as an independent factor of poor prognosis in TNBC patients. The DFS in patients with PD-L1 and HIF-1 偽 co-expression in 3 years was significantly lower than that in patients without co-expression. The co-expression of TNBC and TNBC indicated that the prognosis was poor. 3. The population constitution of PD-L1 and HIF-1 偽 was biased, the proportion of qi stagnation and blood stasis was the largest (54.3%). There was no significant correlation between TCM constitution classification and PD-L1/HIF-1 偽 expression, and there was no significant correlation between TCM constitution classification and survival and prognosis of TNBC patients.
【學位授予單位】：福建中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R737.9
[Abstract]:Objective: 1. To study the expression of PD-L1 and HIF-1 偽 protein in (TNBC) and its correlation with clinicopathological parameters and survival prognosis. To explore the prognostic value of co-expression of PD-L1,HIF-1 偽 in TNBC. 2. To investigate the distribution of TCM physique of TNBC, and to analyze the correlation between constitution and PD-L1,HIF-1 偽 expression and survival prognosis of patients. Methods: 1. 103 patients with TNBC were collected from January 2010 to December 2013 in Fuzhou General Hospital. The clinicopathological data of the patients were collected and their survival and prognosis were followed up. (2) the expression of PD-L1 and HIF-1 偽 was detected by immunohistochemical method. 4. The results were analyzed by SPSS 20.0 software. Results: 1the positive rates of PD-L1 and HIF-1 偽 in TNBC were 30.1% (31 / 103) and 54.4% (56 / 103), respectively. The expression of PD-L1 was positively correlated with tumor size and lymph node metastasis. There was a significant correlation between tumor stage and tumor stage (P < 0.004 / 0. 009 / 0. 000). The expression of HIF-1 偽 was significantly correlated with age, tumor size, histological grade, lymph node metastasis and tumor stage (P0. 0070.0000.0000.0000.000). K 偽 pl 偽 n-Meier survival curve and Log-R 偽 nk analysis: tumor size, TNM stage. Lymph node metastasis and tumor PD-L1,HIF-1 偽 expression could affect the DFS of TNBC patients in 3 years. Further multivariate analysis showed that only tumor PD-L1 expression and TNM staging were independent prognostic factors (P-0.016 ~ 0.002). 2different expression combinations of PD-L1 and HIF-1 偽 in TNBC could affect the survival prognosis of TNBC patients. The 3-year DFS rate in the co-expression group (Shuangyang group) was significantly lower than that in the non-co-expression group (single positive group and double-negative group) (P0. 000). Qi deficiency and yin deficiency. There was no significant difference in the expression of PD-L1 and HIF-1 偽 between different physique types (P < 0. 892P 0. 700), but there was no significant difference in 3 years DFS expression among different physique types (P 0. 655). Conclusion: 1 the expression of PD-L1 and HIF-1 偽 in TNBC is highly expressed, and the expression of PD-L1 and HIF-1 偽 is positively correlated with the poor prognosis, but only PD-L1 can be used as an independent factor of poor prognosis in TNBC patients. The DFS in patients with PD-L1 and HIF-1 偽 co-expression in 3 years was significantly lower than that in patients without co-expression. The co-expression of TNBC and TNBC indicated that the prognosis was poor. 3. The population constitution of PD-L1 and HIF-1 偽 was biased, the proportion of qi stagnation and blood stasis was the largest (54.3%). There was no significant correlation between TCM constitution classification and PD-L1/HIF-1 偽 expression, and there was no significant correlation between TCM constitution classification and survival and prognosis of TNBC patients.
【學位授予單位】：福建中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R737.9
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