子宫内膜癌组织中LAG - 3、TIM - 3、BTLA 的表达情况及意义

目的 研究子宫内膜癌组织中LAG - 3、TIM - 3、BTLA 的表达及其临床意义。方法 选取2012年1月 - 2016年12月于徐州医科大学附属医院行全子宫切除术患者120例，其中术后病理证实为子宫内膜癌组织60例、子宫内膜不典型增生组织30例、正常子宫内膜组织30例。采用免疫组化染色方法，检测LAG - 3、TIM - 3、BTLA 在不同内膜组织中的表达情况，并分析三者的表达与子宫内膜癌患者临床病理特征的相关性。采用 Kaplan - Meier生存分析，COX回归模型分析方法，探索子宫内膜癌患者预后的影响因素。结果 子宫内膜癌组织中，LAG - 3、TIM - 3、BTLA的表达率较子宫内膜不典型增生组、正常子宫内膜组均增高（P均＜0.05）。患者的年龄、分化程度、病理类型均不影响LAG - 3、TIM - 3、BTLA的阳性表达（P均＞0.05），而肿瘤临床分期、淋巴结转移可以影响LAG - 3、TIM - 3、BTLA的表达（P均＜0.05）；肿瘤肌层浸润程度会影响TIM - 3、BTLA的阳性表达，但对LAG - 3的表达无显著影响。Cox回归分析结果显示:FIGO分期、淋巴结转移、LAG - 3、TIM - 3、BTLA蛋白的阳性表达与患者预后相关（P均＜0.05），LAG3、TIM3、BTLA是患者生存的独立危险因素。结论 LAG - 3、TIM - 3、BTLA在子宫内膜癌组织中均有较高表达，且均为患者预后的负性影响因子。

Expression and significance of LAG-3, TIM-3 and BTLA in endometrial carcinoma

Objective To study the expression and clinical significance of LAG-3, TIM-3, BTLA in endometrial carcinoma.Methods From January 2012 to December 2016, 120 patients underwent total hysterectomy in affiliated hospital of Xuzhou medical university were selected, among which 60 cases of endometrial carcinoma tissue, 30 cases of endometrial atypical hyperplasia and 30 cases as normal endometrial tissue were confirmed by postoperative pathology. The method of immunohistochemical staining was used. The expression of LAG-3, TIM-3, BTLA in different intimal tissues was detected,and the correlation between the expression of the three and the clinicopathological features of patients with endometrial carcinoma was analyzed. Kaplan-Meier survival analysis and COX regression model analysis were used to explore the prognostic factors of patients with endometrial cancer. Results In endometrial carcinoma, the expression rate of LAG-3, TIM-3, BTLA was significantly higher than those of the atypical hyperplasia group and the normal endometrial group(P<0.05). The age, differentiation, and pathologic types of the patients did not affect the positive expression of LAG-3, TIM-3, BTLA(P>0.05). However, the expression of LAG-3, TIM-3, BTLA could be affected by clinical stage and lymph node metastasis(P<0.05). The degree of tumor muscle infiltration affected the positive expression of TIM-3 and BTLA. However, there was no significant effect on the expression of LAG-3. COX regression analysis results showed that FIGO staging of patients, lymphatic metastasis and the positive expression of LAG-3, TIM-3 and BTLA protein were correlated with prognosis of patients(P<0.05),and LAG-3, TIM-3 and BTLA were independent risk factors for patient survival. Conclusion LAG-3, TIM-3 and BTLA are all highly expressed in endometrial cancer tissues and are negative influencing factors for patients’ prognosis.