【摘要】 目的 分析程序性死亡受体-配体1(PD-L1)、E-钙黏蛋白(E-cad)、N-钙黏蛋白(N-cad)、信号转导及转录激活子3(STAT3)表达与胸腺癌术后化疗患者预后的关系。方法 我院就诊的69例胸腺癌患者，均手术治疗并于术后化疗，分析PD-L1、E-cad、N-cad、STAT3在胸腺癌组织及胸腺正常组织中的表达情况及与临床病理特征的关系，收集患者术后3年的预后生存结局，绘制生存曲线比较阳性表达组和阴性表达组生存率差异，采用COX回归模型分析患者预后影响因素。结果 胸腺癌组织中PD-L1、N-cad、STAT3表达阳性率高于正常胸腺组织，E-cad表达阳性率低于正常胸腺组织(P<0.05);不同TNM病理分期、Masaoka-Koga分期、淋巴结转移情况患者组织中PD-L1、E-cad、N-cad、STAT3表达比较，不同肿瘤直径患者组织中PD-L1、STAT3的表达比较，差异均有统计学意义(P<0.05);随访至术后3年，69例患者中51例存活(73.91%),18例死亡(26.09%);PD-L1、N-cad、STAT3表达阳性组术后3年生存率低于阴性组，E-cad表达阳性组术后3年生存率高于阴性组(P<0.05);不同TNM病理分期、Masaoka-Koga分期、淋巴结转移情况、手术切除情况、PD-L1、E-cad、N-cad、STAT3表达的胸腺癌患者术后3年生存率比较，差异均有统计学意义(P<0.05);TNM病理分期、Masaoka-Koga分期、手术切除程度、PD-L1表达、STAT3表达均为影响胸腺癌患者预后的独立预测因素(P<0.05)。结论 PD-L1、STAT3阳性表达是胸腺癌患者术后预后的独立危险因素。更多还原

【Abstract】 Objective To analyze the relationship between the expressions of programmed cell death-ligand 1(PD-L1), E-cadherin(E-cad), N-cadherin(N-cad), signal transducer and activator of transcription 3(STAT3) and the prognosis of patients after thymic carcinoma chemotherapy.Methods A total of 69 patients with thymic carcinoma treated in our hospital were enrolled. All patients underwent surgical treatment and then chemotherapy. The expressions of PD-L1, E-cad, N-cad and STAT3 in thymic carcinoma tissues and normal thymus tissues were detected, and their relationship with clinicopathological characteristics was analyzed. The prognosis outcomes of patients after 3 years of surgery were collected. The differences in survival rate between positive expression group and negative expression group were compared with survival curves. The influencing factors of prognosis were analyzed by using COX regression model.Results The positive expression rates of PD-L1, N-cad and STAT3 in thymic carcinoma tissues were higher than those in normal thymus tissues, while positive expression rate of E-cad was lower than that in normal thymus tissues(P<0.05). There were significant differences in PD-L1, E-cad, N-cad and STAT3 among patients with different TNM stages, Masaoka-Koga stage and lymph node metastasis, and there were significant differences in PD-L1 and STAT3 among patients with different tumor diameter(P<0.05). After 3 years of postoperative follow-up, there were 51 survival cases(73.91%) and 18 death cases(26.09%). The survival rates after 3 years of surgery in the positive PD-L1, N-cad and STAT3 groups were lower than those in the negative groups, while the survival rate was higher in the positive E-cad group than the negative E-cad group(P<0.05). The results of univariate COX analysis showed that TNM stage, Masaoka-Koga stage, lymph nodes metastasis, surgical excision, PD-L1, E-cad, N-cad and STAT3 were all related to prognosis of patients with thymic carcinoma(P<0.05). The differences were statistically significant when 3-year survival rate of thymic carcinoma patients with different TNM pathological stage, Masaoka-Koga stage, lymph node metastasis, surgical resection, and expressions of PD-L1, E-cad, N-cad and STAT3 were compared(P<0.05). TNM stage, Masaoka-Koga stage, surgical excision, PD-L1 and STAT3 were independent predictors of prognosis of the patients(P<0.05).Conclusion The positive expressions of PD-L1 and STAT3 are independent risk factors of prognosis in patients with thymic carcinoma.更多还原