趋化因子CXCL5和程序性死亡配体 1在结肠直肠癌组织的表达与病人预后的关系

doi:10.16139/j.1007-9610.2021.06.017

摘要/Abstract

摘要：

目的：分析CXCL5（C-X-C motif ligand 5）蛋白与程序性死亡配体1（programmed death ligand 1，PD-L1）在结肠直肠癌组织中的表达，并探讨两者与临床特征的关系及预后价值。方法：收集2010年至2011年行腹腔镜切除手术的结肠直肠癌病人肿瘤组织及癌旁正常组织标本，共78例。同时对所有病例进行临床资料收集及预后随访。标本制备组织芯片，行免疫组织化学染色。采用免疫危险评分标准对CXCL5、PD-L1表达进行评分，分析其表达与各项临床病理参数关系。最后分析CXCL5、PD-L1表达与结肠直肠癌病人预后的关系。结果：结肠直肠癌组织中CXCL5、PD-L1表达均高于癌旁正常组织，与肿瘤直径、TNM分期相关。Cox单因素回归分析显示，TNM分期、CXCL5高表达、PD-L1高表达是结肠直肠癌病人总生存率的预后危险因素。多因素回归分析显示，TNM分期和PD-L1高表达是结肠直肠癌病人总生存率的独立预后危险因素。CXCL5与PD-L1均高表达的病人预后最差。结论：CXCL5与PD-L1联合可对结肠直肠癌病人进行危险度分层，预测病人预后。

关键词: 结肠直肠癌, CXCL5, 程序性死亡配体1

Abstract: Objective To analyze the expression of CXCL5 (C-X-C motif ligand 5) and programme death ligand 1 (PD-L1) in colorectal cancer tissues and explore two chemokines associated with clinical characteristics and prognosis. Methods The specimens of tumor tissues and adjacent normal tissues were collected from 78 patients with colorectal cancer who had laparoscopic resection from 2010 to 2011. The clinical data were gotten and follow-up were done for prognosis. Tissue microarrays were made from all specimens and immunohistochemical staining was performed. Expression of CXCL5 and PD-L1 was evaluated using immune risk scoring and analyzed with the association of clinical pathological parameters and prognosis of patients. Results Expression of CXCL5 and PD-L1 was associated with tumor size and TNM stage, and was higher in colorectal cancer tissues than in adjacent normal tissues. Cox univariate regression analysis showed that TNM stage, high expression of both CXCL5 and PD-L1 were the prognostic risk factors for overall survival of colorectal patients. It was shown with multivariate regression analysis that TNM stage and high expression of PD-L1 were the independent prognostic risk factors for overall survival rate. Patients with higher expression of both CXCL5 and PD-L1 had the worst prognosis. Conclusions CXCL5 combined with PD-L1 could stratify the risk of patients with colorectal cancer and predict the prognosis of patients.

Key words: Colorectal cancer, CXCL5, Programmed death ligand 1

中图分类号:

刘诗光, 赵敬坤, 陆爱国, 毛志海. 趋化因子CXCL5和程序性死亡配体 1在结肠直肠癌组织的表达与病人预后的关系[J]. 外科理论与实践, 2021, 26(06): 543-549.

LIU Shiguang, ZHAO Jingkun, LU Aiguo, MAO Zhihai. Expression of chemokine CXCL5 and programme death ligand 1 in colorectal cancer tissues are associated with prognosis of patients[J]. Journal of Surgery Concepts & Practice, 2021, 26(06): 543-549.

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临床特征	CXCL5表达		统计学数值	P值	PD-L1表达		统计学数值	P值
临床特征	高	低	统计学数值	P值	高	低	统计学数值	P值
总计	48	30			37	41
性别			1.086	0.297			1.236	0.266
男	23	18			17	24
女	25	12			20	17
年龄（岁）			0.194	0.660			0.360	0.549
<65	28	19			21	26
≥65	20	11			16	15
组织学			3.534	0.171			2.982	0.225
管状	38	28			29	37
黏液	9	2			7	4
乳头状	1	0			1	0
肿瘤直径（cm）			3.945	0.047			4.029	0.045
≥5	27	10			22	15
<5	21	20			15	26
TNM分期			2.735	0.003			11.733	0.008
Ⅰ	5	10			4	10
Ⅱ	21	12			11	16
Ⅲ	16	8			16	15
Ⅳ	6	0			6	0

参数	总生存率
参数	HR	95% CI	P值
单因素分析
年龄（岁）（<65比≥65）	1.003	0.410~2.454	0.995
性别（女比男）	1.812	0.740~4.433	0.193
组织学
乳头状	1.000	..	0.222
管状比乳头状	0.164	0.021~1.272	0.084
黏液比乳头状	0.198	0.020~1.948	0.165
TNM分期
Ⅲ+Ⅳ比Ⅰ+Ⅱ	0.181	0.060~0.541	0.002
肿瘤直径（<5 cm比≥5 cm）	0.537	0.219~1.314	0.173
CXCL5（低表达比高表达）	0.229	0.067~0.783	0.019
PD-L1（低表达比高表达）	0.397	0.164~0.958	0.040
多因素分析
TNM分期
Ⅲ+Ⅳ比Ⅰ+Ⅱ	0.235	0.075~0.734	0.013
CXCL5（低表达比高表达）	0.786	0.202~3.063	0.728
PD-L1（低表达比高表达）	0.156	0.042~0.584	0.006
TNM分期
Ⅲ+Ⅳ比Ⅰ+Ⅱ	0.234	0.076~0.721	0.011
CXCL5（低表达比高表达）	0.345	0.098~1.215	0.098