摘要
目的探讨血清可溶性CD276(sCD276)与晚期高级别浆液性卵巢癌(HGSOC)预后及肿瘤免疫浸润的相关性。方法将2017年3月至2020年3月资阳市第一人民医院就诊的晚期HGSOC患者73例纳入A组,选取同期入院治疗的其他类型卵巢癌患者80例纳入B组,另选择80名健康人群作为健康人群组,检测三组血清sCD276表达水平。并依据血清sCD276表达水平中位数将A组分为高表达组(≥451.26 pg/ml)与低表达组(<451.26 pg/ml)。分析血清sCD276水平变化与晚期HGSOC患者不同临床特征的关系,并采用生存曲线和Cox比例风险回归分析血清sCD276与晚期HGSOC预后的相关性。结果A组和B组血清sCD276表达水平均高于健康人群组(P<0.05),且A组血清sCD276水平高于B组(P<0.05);卵巢癌患者sCD276低表达与高表达的无病生存率比较,差异无统计学意义(P>0.05);在A组中,低表达组的无病生存率及总生存率高于高表达组(P<0.05),无病生存时间≥12月组的血清sCD276表达水平低于无病生存时间<12月组(P<0.05);A组患者中sCD276高表达组与低表达组在有无淋巴结转移、术后残余病灶、CD3^(+)阳性、FoxP3^(+)阳性等方面比较有差异统计学意义(P<0.05);经多因素COX比例风险回归分析得出,有术后残余病灶、CD3^(+)阳性、FoxP3^(+)阳性、血清sCD276≥451.26 pg/ml均是晚期HGSOC患者预后的危险因素(P<0.05);经免疫组化法对肿瘤组织检测得出,A组中有59例患者膜CD276表达为阳性,14例患者膜CD276表达为阴性,膜CD276阳性组的血清sCD276表达及FoxP3^(+)阳性比例均明显高于膜CD276阴性组(P<0.05)。结论血清sCD276在晚期HGSOC呈高表达水平,其水平升高与TILs标志物FoxP3^(+)T细胞数量均是晚期HGSOC患者复发或死亡的危险因素,与患者预后关系密切,血清sCD276为晚期HGSOC新辅助化疗期间的免疫应答监测提供了可能性。
Objective To explore the correlation between the serum soluble CD276(sCD276)and the prognosis and tumor immune infiltration in advanced high-grade serous ovarian cancer(HGSOC).Methods From March 2017 to March 2020,73 patients with advanced HGSOC hospitalized in Ziyang First People's Hospital were included in a group A and 80 patients with other types of ovarian cancer hospitalized at the same time were included in a group B.Another 80 healthy people were selected as a healthy population group.Serum sCD276 expression levels in the three groups were detected.The group A was divided into a high expression group(≥451.26 pg/ml)and a low expression group(<451.26 pg/ml)based on the median serum sCD276 expression level.The relationship between changes in serum sCD276 levels and different clinical characteristics in patients with advanced HGSOC was analyzed.The survival curves and Cox proportional risk regression were used to analyze the correlation between serum sCD276 levels and the prognosis of advanced HGSOC.Results The expression levels of serum sCD276 in the group A and B were higher than those in the healthy population group(P<0.05),and the serum sCD276 level of the group A was higher than that of the group B(P<0.05).There was no statistically significant difference in the mean disease-free survival rate between low and high expression of sCD276 in ovarian cancer patients(P>0.05).In the group A,the average disease-free survival rate and overall survival rate of patients with low expression were higher than those of patients with high expression group(P<0.05).The serum sCD276 expression level of patients with disease-free survival time≥12 months was lower than that of patients with disease-free survival time<12 months(P<0.05).There was a statistically significant difference between patients with high expression and patients with low expression of sCD276 in the presence or absence of lymph node metastasis,postoperative residual lesions,CD3+positivity,and FoxP3+positivity in the group A(P<0.05).Multivariate COX proportional risk regression analysis showed that residual lesions after surgery,CD3+positive,FoxP3+positive,and serum sCD276≥451.26 pg/ml were risk factors for the prognosis of advanced HGSOC patients(P<0.05).Immunohistochemical detection of tumor tissue showed that 59 patients in the group A had positive membrane CD276 expression,while 14 patients had negative membrane CD276 expression.The serum sCD276 expression and FoxP3+positive proportion in patients with positive membrane CD276 were significantly higher than those in patients with negative membrane CD276(P<0.05).Conclusions Serum sCD276 is highly expressed in advanced HGSOC.Its elevated levels and the number of TILs marker FoxP3+T cells are risk factors for recurrence or death in patients with advanced HGSOC.Therefore,it is closely related to patients'prognosis.Serum sCD276,also provides a possibility for immune response monitoring during neoadjuvant chemotherapy in advanced HGSOC.
作者
蒋艳
黎雪梅
邹吴春
任丽
何春
阳袁莉
JIANG Yan;LI Xue-mei;ZOU Wu-chun;REN Li;HE Chun;YANG Yuan-li(Department of Gynecology,Ziyang Hospital,West China Hospital,Sichuan University,Ziyang 641300,China;Department of Obstetrics and Gynecology,Chengdu Women and Children′s Central Hospital,Chengdu 610000,China)
出处
《实用医院临床杂志》
2024年第1期123-127,共5页
Practical Journal of Clinical Medicine
基金
成都市卫生健康委员会医学科研基金资助项目(编号:2022024)。
