【摘要】 目的 探讨食管癌患者淋巴细胞表面T细胞免疫球蛋白黏蛋白分子3(Tim-3)、程序性死亡因子-1(PD-1)、程序性死亡1-配体(PD-L1)表达及预测术后早期复发的价值。方法 选取郑州大学第一附属医院2021年1月—2022年7月期间收治的86例食管癌患者术后癌组织、术后距切缘>5 cm癌旁正常组织，统计对比不同组织、临床病理特征Tim-3、PD-1、PD-L1表达，分析临床病理特征与Tim-3、PD-1、PD-L1表达相关性，随访6个月统计复发率，比较复发与未复发患者Tim-3、PD-1、PD-L1表达，分析Tim-3、PD-1、PD-L1表达对术后早期复发的预测价值。结果 癌组织Tim-3、PD-1、PD-L1阳性表达高于癌旁组织(P<0.05);癌组织Tim-3表达对比：低分化、病变最大径>3 cm、淋巴结转移、TNM分期中Ⅲ期的阳性表达率均高于其他病理特征(P<0.05);癌组织PD-1表达对比：TNM分期中Ⅲ期的阳性表达率高于Ⅰ期、Ⅱ期(P<0.05);癌组织PD-L1表达对比：病变最大径>3 cm、淋巴结转移、TNM分期中Ⅲ期的阳性表达量高于其他病理特征(P<0.05);癌组织Tim-3表达与分化程度呈负相关，与病变最大径、淋巴结转移、TNM分期呈正相关(P<0.05);癌组织PD-1表达与TNM分期呈正相关(P<0.05);癌组织PD-LI表达与病变最大径、淋巴结转移、TNM分期呈正相关(P<0.05);复发患者癌组织Tim-3、PD-1、PD-L1阳性表达率高于未复发患者(P<0.05);ROC曲线结果为，癌组织Tim-3、PD-1、PD-L1表达水平联合预测食管癌患者术后早期复发的AUC为0.881,最佳诊断敏感度、特异度分别为86.96%、90.48%(P<0.05)。结论 食管癌患者癌组织Tim-3、PD-1、PD-L1阳性表达率高，动态检测有利于早期评估病情，联合应用时能有效预测术后早期复发风险，为临床制定防治措施提供依据。更多还原

【Abstract】 Objective To investigate the value of lymphocyte surface T-cell immunoglobulin mucin molecule 3(Tim-3), programmed death factor-1(PD-1), programmed death 1-ligand(PD-L1) expression and prediction of early postoperative recurrence in patients with esophageal cancer.Methods Eighty-six patients with esophageal cancer admitted to our hospital between January 2021 and July 2022 were selected from postoperative cancer tissues and normal postoperative paracancerous tissues >5 cm from the incision margin, and the expression of Tim-3, PD-1 and PD-L1 in different tissues and clinicopathological characteristics were compared.Results Positive expression of Tim-3, PD-1 and PD-L1 in cancer tissues was higher than that in paraneoplastic tissues(P<0.05); Comparison of Tim-3 expression in cancer tissues: the positive expression rates of hypofractionated, lesion maximum diameter >3 cm, lymph node metastasis and stage Ⅲ in TNM stage were higher than those of other pathological features(P<0.05); Comparison of PD-1 expression in cancer tissues: the positive expression of stage Ⅲ in TNM stage; In comparison of PD-L1 in cancer tissues: positive expression of stage Ⅲ cases, characterized by a lesion maximum diameter than 3 cm and lymoh node metastasis, was higer than in other cases. The expression of Tim-3 in cancer tissues was negatively correlated with the degree of differentiation and positively correlated with the maximum diameter of the lesion, lymph node metastasis and TNM stage(P<0.05). The expression of PD-1 in cancer tissues was positively correlated with TNM stage(P<0.05); the expression of PD-LI in cancer tissues was positively correlated with the maximum diameter of lesion, lymph node metastasis and TNM stage(P<0.05); the positive expression of Tim-3, PD-1 and PD-L1 in cancer tissues was higher in patients with recurrence than in patients without recurrence(P<0.05); the results of ROC curve were that the expression of Tim-3, PD-1 and PD-L1 in cancer tissues PD-1 and PD-L1 expression levels combined to predict early postoperative recurrence in patients with esophageal cancer had an AUC of 0.881, with the best diagnostic sensitivity and specificity of 86.96% and 90.48%, respectively(P<0.05).Conclusion Tissues, dynamic testing is beneficial for early assessment of the disease and can effectively predict the risk of early recurrence after surgery when used in combination, providing a basis for clinical formulation of prevention and control measures.更多还原