| 结直肠癌中炎症成纤维细胞、PD-L1的表达与临床病理特征及预后的相关性 |
| 投稿时间：2024-11-07 修订日期：2024-12-29 点此下载全文 |
| 引用本文：何乐,杨楠,向奇,高欣语,常守凤,刘凤磊.结直肠癌中炎症成纤维细胞、PD-L1的表达与临床病理特征及预后的相关性[J].医学研究杂志,2025,54(5):148-157 |
| DOI：
10.11969/j.issn.1673-548X.2025.05.027 |
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| 基金项目:国家卫生健康委员会胃肠肿瘤诊治重点实验室2022年度硕博士/博士后基金资助项目(NHCDP2022021)；甘肃省人民医院院内科研基金资助项目(21GSSYB-19) |
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| 中文摘要:目的 探讨结直肠癌(colorectal cancer, CRC)中炎症成纤维细胞(inflammatory cancer associated fibroblast, iCAF)和原发灶肿瘤细胞(tumor cell, TC)、肿瘤浸润免疫细胞(tumor-infiltrating immune cell, TIIC)中程序性死亡-配体1(programmed death-ligand1, PD-L1)的表达与临床病理特征及预后的相关性。方法 采用免疫组化法,分别用PDGFRa和RGS5标记iCAF,检测2019~2021年笔者医院120例CRC中PDGFRa、RGS5(瘤中间质、肿瘤浸润前缘间质)和TC、TIIC中PD-L1的表达,分析癌组织iCAF和PD-L1的表达与临床病理特征及总生存期(overall survival, OS)的关系。结果 120例结直肠癌患者瘤中间质中PDGFRa高表达率为56.7%(68/120),RGS5高表达率为47.5%(57/120),PDGFRa和RGS5的高表达率为39.2%(47/120),PDGFRa及RGS5的高表达与肿瘤出芽、区域淋巴结转移有关。肿瘤浸润前缘间质中PDGFRa高表达率为71.7%(86/120), RGS5的高表达率为57.5%(69/120),PDGFRa和RGS5的高表达率为47.5%(57/120),PDGFRa及RGS5的高表达与肿瘤出芽、区域淋巴结转移、T分期有关。TC PD-L1阳性率为5.8％(7/120), TIIC PD-L1阳性率为48.3％(58/120),TC PD-L1的表达与区域淋巴结转移有关。Kaplan-Meier及Log-rank结果显示,患者OS与组织学分级、淋巴结转移、肿瘤出芽、TIIC PD-L1、PDGFRa和RGS5(瘤中间质、肿瘤浸润前缘间质)的表达有关。COX单因素和多因素回归分析显示,组织学分级、淋巴结转移、TIIC PD-L1、RGS5(瘤中间质、肿瘤浸润前缘间质)、PDGFRa(肿瘤浸润前缘间质)的表达是影响CRC患者OS的独立预后因素。PDGFRa(瘤中间质)的表达与TC PD-L1的表达呈负相关(r=-0.213,P=0.020)。RGS5(瘤中间质)的表达与TC PD-L1的表达呈负相关(r=-0.183,P=0.046)。结论 CRC中iCAF的表达与TC PD-L1的表达呈负相关,靶向CRC中iCAF的治疗可能使其获益, 检测TC PD-L1、TIIC PD-L1表达可为临床免疫治疗的疗效及预后提供参考。 |
| 中文关键词:结直肠癌 iCAF PDGFRa RGS5 PD-L1 肿瘤出芽 预后 |
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| Correlation of Inflammatory Fibroblasts and PD-L1 Expression with Clinicopathological Features and Prognosis in Colorectal Cancer |
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| Abstract:Objective To investigate the relationship between the appearance of ligand 1 in inflammatory fibroblasts, primary tumorous cells, tumor Impregna-ted immune-free cellulars and clinical pathologic signs in colorectal carcinoma.Methods The group method of immunization was used, and PDGFRa and RGS5 were used to mark iCAF.The levels of PDGFRa, RGS5 (mesenchyma, mesenchyma prior to tumor infiltration) and PD-L1 in TC and TIIC were detected in 120 CRC patients in our hospital from 2019 to 2021.To analyze the relationship between the appearance of iCAF and PD-L1 in cancer tissues and clinical pathologic signs and overall survival (OS). Results The high rate of PDGFRa and RGS5 was 56.7% (68/120) and 47.5% (57/120) in the mesenchyma of 120 patients with colorectal carcinoma.The high detection rate of PDGFRa and RGS5 was 39.2% (47/120).The high surface level of PDGFRa and RGS5 is related to the emergence of neoplastic buds and the metastasis of luoba nodules in the region.The high surface reach rate of PDGFRa was 71.7% (86/120) and that of RGS5 was 57.5% (69/120).The high detection rate of PDGFRa and RGS5 was 47.5% (57/120).The high surface level of PDGFRa and RGS5 is related to the emergence of tumor buds, the metastasis of lubaria in the region, and the phase of T.The positive rate of TC PD-L1 was 5.8% (7/120) and that of TIIC PD-L1 was 48.3% (58/120). The surface reach of TC PD-L1 is related to the regional luoba nodal transfer.Kaplan-Meier and Log-rank results were shown.The patient′s OS was associated with histological grading, neoplasmic metastasis, neoplasmic budding, TIIC PD-L1, PDGFRa, and RGS5 (mesenchyma, mesenchyma prior to neoplasmic infiltration). COX monofactor and polyfactor regression analysis showed:Histologic grading, luba metastasis, TIIC PD-L1, RGS5 (mesenchyma, mesenchyma prelimbic) and PDGFRa (mesenchyma prelimbic) are independent of OS in patients with CRCCreate a preemptive factor.The surface reach of PDGFRa (mesenchymal) was negatively correlated with that of TC PD-L1 (r=-0.213, P=0.020).The surface reach of RGS5 (mesenchymal) was negatively correlated with that of TC PD-L1 (r=-0.183, P=0.046).Conclusion In CRC, iCAF has a negative correlation with TC PD-L1.Targeting the treatment of iCAF in CRC may benefit it, and the detection of TC PD-L1 and TIIC PD-L1may provide reference for the therapeutic effect of clinical anti-epidemic therapy and the prediction of CRC. |
| keywords:Colorectal carcinoma iCAF PDGFRa RGS5 PD-L1 Tumor budding Antedate |
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