老年肺腺癌手术患者程序性死亡受体配体1表达及临床病理意义和预后分析

Expression of programmed death receptor ligand 1 in elderly patients undergoing surgery for lung adenocarcinoma and analy-sis of its clinicopathological significance and prognosis

中文关键词: 老年  肺腺癌  程序性死亡受体配体1  预后

英文关键词: elderly  lung adenocarcinoma  programmed death receptor ligand 1  prognosis

中文摘要:

      目的 探讨老年肺腺癌手术患者的程序性死亡受体配体1(PD-L1)表达情况及临床病理意义和预后.方法 回顾性分析2021 年1 月—2021 年8 月于复旦大学附属华东医院胸外科收治的70 例老年肺腺癌手术患者资料.根据PD-L1表达情况将受试者分为PD-L1 阳性组(n =28)和PD-L1 阴性组(n =42).比较2 组的年龄、性别、吸烟史、肿瘤分期、T分期、N分期、胸膜侵犯情况、肿瘤大小、术前血清癌胚抗原、肿瘤分化程度及脉管癌栓情况.分析不同临床病理特征对患者预后的影响.结果 与PD-L1 阴性组比较,PD-L1 阳性组男性患者较多,肿瘤分期、N分期较差,肿瘤分化程度较低,脉管癌栓发生率较高,差异均有统计学意义(P＜0.05).70 例老年肺腺癌患者死亡 17 例,存活 53 例,生存率为 75.71%(53/70).PD-L1 阳性、Ⅲ期及以上和低分化患者预后较差(P＜0.05).结论 PD-L1 表达一定程度上与肿瘤分期、N分期、分化程度、脉管癌栓和性别相关,且PD-L1 阳性表达的老年患者预后可能较差.

英文摘要:

      Objective To investigate the expression of programmed death receptor ligand 1(PD-L1)and its clinico-pathological significance and prognosis in elderly patients undergoing surgery for lung adenocarcinoma.Methods The data of 70 elderly patients with lung adenocarcinoma who underwent surgery in Department of Thoracic Surgery of Huadong Hospital Affiliated to Fudan University from January 2021 to August 2021 were retrospectively analyzed.According to PD-L1 expres-sion,they were divided into PD-L1 positive group(n =28)and PD-L1 negative group(n =42).Age,gender,smoking histo-ry,tumor stage,T stage,N stage,pleural invasion,tumor size,preoperative serum carcinoembryonic antigen level,tumor dif-ferentiation degree and vascular tumor thrombus status were compared between the two groups.The impacts of different clinico-pathological features on the prognosis of patients were analyzed.Results Compared with the PD-L1 negative group,there were more male patients in the PD-L1 positive group,worse tumor stage and N stage,poorer tumor differentiation degree,and higher incidence of vascular cancer thrombus,with statistical significances(P＜0.05).Among 70 elderly patients with lung adenocarcinoma,17 died and 53 survived,with a survival rate of 75.71%(53/70).The patients with PD-L1 positive expres-sion,stage Ⅲ and above,and poor differentiation had a poorer prognosis(P＜0.05).Conclusion The expression of PD-L1 is to some extent related to tumor stage,N-stage,differentiation degree,vascular cancer thrombus and gender.The elderly pa-tients with PD-L1 positive expression may have a poor prognosis.