免疫评分在肝癌患者中的预后研究

doi:10.13418/j.issn.1001-165x.2021.01.016

中国临床解剖学杂志 ›› 2021, Vol. 39 ›› Issue (1): 82-89.doi: 10.13418/j.issn.1001-165x.2021.01.016

免疫评分在肝癌患者中的预后研究

张浩楠^{1, 2}，　张林枝^{2, 3}，　高炜²，　徐彦²，　杨雪玲²，　于海鹏²，　邢文阁²，　司同国²

1.天津市第一中心医院放射科，天津影像医学研究所，天津 300192； 2.天津医科大学肿瘤医院介
入治疗科，国家肿瘤临床医学研究中心，天津市肿瘤防治重点实验室，天津市恶性肿瘤临床医学研究
中心，天津 300060； 3.解放军总医院第五医学中心介入科，北京 100039

收稿日期:2019-12-26 出版日期:2021-01-25 发布日期:2021-01-27
通讯作者: 司同国，博士，副主任医师，E-mail：drsitg@163.com
作者简介:张浩楠（1992-），北京人，硕士，研究方向：消融与免疫的基础与临床研究，E-mail：tmuzhn@163.com
基金资助:
国家自然科学基金(81471761，81501568)，天津市科技支撑计划重点项目（15ZCZDSY00890）

The prognostic role of immunoscore in patients with hepatocellular carcinoma

Zhang Haonan^1,2, Zhang Linzhi^2,3, Gao Wei², Xu Yan², Yang Xueling², Yu Haipeng², Xing Wengeng², Si Tongguo²

1. Department of Radiology, Tianjin First Central Hospital, Tianjin Institute of Imaging Medicine, Tianjin 300192; 2. Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, Key Laboratory of Cancer Prevention and Therapy of Tianjin, Tianjin’s Clinical Research Center for Cancer Tianjin 300060, China; 3. The Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, China

Received:2019-12-26 Online:2021-01-25 Published:2021-01-27

摘要/Abstract

摘要： 目的　探讨免疫评分及PD-L1在肝癌组织的表达情况，分析肝癌患者的免疫评分与其临床病理特征及预后的关系。方法　采用免疫组化检测免疫评分与PD-L1在61例肝癌患者中的表达，分析PD-L1、免疫评分与临床病理特征及预后之间的关系。结果　肝癌中免疫评分较高的表达率为26.2%，较低的表达率为73.8%。统计分析发现免疫评分与AFP增高（P<0.05）及肝内复发（P>0.05）具有相关性；而与患者年龄、性别、肿瘤直径、分化程度、脉管癌栓等临床因素无相关性（P>0.05）。生存分析发现免疫评分较高患者的总生存期与无复发生存期显著高于免疫评分较低的患者（χ2=11.39，P<0.01；χ2=14.78，P<0.01）。肝癌组织PD-L1的阳性表达率为44.3%，对应癌旁低表达，具有统计学差异（χ2=7.313，P<0.01）。PD-L1阳性患者的总生存期与无复发生存期低于PD-L1阴性患者（χ2=5.598，P<0.05；χ2=10.90，P<0.01）。肝癌组织中PD-L1与免疫评分间具有负相关性（χ2=12.703，P<0.01）。结论　免疫评分可作为患者预后的一个标志物，免疫评分高的患者预后较好，反之易早期复发且预后较差；肝癌组织PD-L1与免疫评分之间具有负相关性。

关键词: 免疫评分, 　PD-L1, 　肝癌, 　预后

Abstract: Objective　To investigate the expression of immunoscore and PD-L1 in hepatocellular carcinoma(HCC), and to analyze the relationship between the expression of PD-L1 and immunoscore and the clinicopathological characteristics and prognosis of HCC.　Methods　Immunohistochemical staining was used to detect the expression of immunoscore and PD-L1 in 61 cases of hepatocellular carcinoma tissue, and to analyze the relationship between the expression of immunoscore and PD-L1 in hepatocellular carcinoma and different clinicopathological features and prognosis．Results　The expression rate of high-immunoscore was 26.2%, the low-immunoscore expression rate was 73.8%. In clinical indicators，the positive expression rate of immunoscore was negatively related to patient's preoperative AFP level (P<0.005), and intrahepatic recurrence (P<0.05), but not to factors of patient’s age, gender, tumor size, differentiation, and non-vascular invasion correlated (P>0.05). Kaplan–Meier analysis presented that the immunoscore showed good stratification between high-immunoscore and low-immunoscore groups in both overall survival (P<0.01) and progression-free survival (P<0.01), respectively. The positive expression rate of PD-L1 in hepatocellular carcinoma was 44.3%, which was significantly higher than that in normal control group (P<0.01).Kaplan-Meier analysis presented that the PD-L1-positive patients was significantly lower in patients with negative PD-L1-negative patients. In clinical indicators，the positive expression rate of PD-L1 was negatively related to patient’s immunoscore (P<0.01)．Conclusions　The expression of immunoscore can be used as an important prognostic maker for patients with hepatocellular carcinoma. Patients with high-immunoscore are significantly associated with a prolonged OS and PFS, however patients with low-immunoscore are more likely to occur early recurrence, prognosis is even worse. The positive expression rate of PD-L1 is negatively related to patient’s immunoscore.

Key words: Immunoscore, 　PD-L1, 　Prognosis, 　Hepatocellular carcinoma

中图分类号:

张浩楠, 张林枝, 高炜, 徐彦, 杨雪玲, 于海鹏, 邢文阁, 司同国. 免疫评分在肝癌患者中的预后研究[J]. 中国临床解剖学杂志, 2021, 39(1): 82-89.

Zhang Haonan, Zhang Linzhi, Gao Wei, Xu Yan, Yang Xueling, Yu Haipeng, Xing Wengeng, Si Tongguo. The prognostic role of immunoscore in patients with hepatocellular carcinoma[J]. Chinese Journal of Clinical Anatomy, 2021, 39(1): 82-89.

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免疫评分在肝癌患者中的预后研究

The prognostic role of immunoscore in patients with hepatocellular carcinoma

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