PD-L1、CPEB4和GRP在脑胶质瘤中的表达及与临床病理特征和预后的关系研究

目的分析程序性死亡受体-配体1(PD-L1)、胞质多聚腺苷酸化成分结合蛋白4(CPEB4)、胃泌素释放肽(GRP)在脑胶质瘤中的表达及与临床病理特征和预后的关系。方法回顾性选取辽宁省健康产业集团铁煤总医院2015年2月至2018年11月收治的94例脑胶质瘤患者取手术切除的癌组织作为脑胶质瘤组(94例)同时取距离肿瘤组织5 mm处的组织作为癌旁组(94例),另取同期颅脑损伤减压术切除的脑组织作为正常对照组(87例)。采用免疫组化法检测三组PD-L1、CPEB4、GRP表达情况;分析PD-L1、CPEB4、GRP在脑胶质瘤患者不同临床病理特征中的表达差异,并比较预后良好组和预后不良组临床病理特征脑胶质瘤组织中PD-L1、CPEB4、GRP表达;通过Logistic回归分析PD-L1、CPEB4、GRP对预后的影响。结果脑胶质瘤组患者组织中PD-L1、CPEB4、GRP强阳性及阳性表达率高于癌旁组、正常对照组差异有统计学意义(P <0.05)。脑胶质瘤组织中PD-L1、CPEB4、GRP在WHO分级Ⅲ~Ⅳ级中阳性率高于Ⅰ~Ⅱ级在KPS评分<80分患者中阳性率高于KPS评分≥80分患者差异有统计学意义(P<0.05)。患者随访1~3年,出现复发者16例(17.02%),肿瘤源性死亡4例(4.26%),预后不良共20例(21.28%)。预后不良组患者PD-L1、CPEB4、GRP阳性表达率高于预后良好组差异有统计学意义(P <0.05)。多因素Logistic回归分析结果显示,PD-L1、CPEB4、GRP阳性是脑胶质瘤患者预后不良的危险因素(B=2.535、2.164、2.373,95%CI=1.513~105.257、1.764~42.973、1.274~90.311,均P<0.05)。结论 PD-L1、CPEB4、GRP在脑胶质瘤组织中阳性表达率增高且与WHO分级、KPS评分有关,并影响患者预后,检测PD-L1、CPEB4、GRP对脑胶质瘤患者的病理分级和预后评估具有重要意义。

Expression of PD-L1,CPEB4 and GRP in gliomas and their relationship with clinicopathological features and prognosis

Objective To analyze the expression of programmed death receptor-ligand 1(PD-L1),cytoplasmic polyadenylation element binding protein 4(CPEB4) and gastrin releasing peptide(GRP) in glioma and their relationship with clinicopathological features and prognosis.Methods Ninety-four patients with glioma admitted to our hospital from February 2015 to November 2018 were enrolled.The surgically resected cancer tissue was used as the glioma group(94 cases),and the tissue at 5 mm from the tumor tissue was taken.As a paracancerous group(94 cases),the brain tissue removed by decompression of brain injury at the same time was taken as a normal control group(87 cases).Immunohistochemistry was used to detect the expression of PD-L1,CPEB4 and GRP in three groups.The expression differences of PD-L1,CPEB4 and GRP in different clinicopathological features of glioma patients were analyzed.And compare the clinicopathological characteristics of good prognosis group and poor prognosis group,PD-L1,CPEB4,GRP expression in glioma tissue.Logistic regression analysis of PD-L1 and CPEB4 was performed.The impact of GRP on prognosis.Results The positive and positive expression rates of PD-L1,CPEB4 and GRP in the glioma group were higher than those in the paracancerous group and the normal control group(P <0.05).The positive rate of PD-L1,CPEB4 and GRP in glioma tissues was higher than Ⅰ~Ⅱ in WHO grade Ⅲ~Ⅳ.The positive rate in patients with KPS score <80 was higher than that in patients with KPS score≥80 statistically significant(P <0.05).The patients were followed up for 1~3 years.There were 16 cases(17.02%) with recurrence,4 cases(4.26%) with tumor-derived death,and 20 cases(21.28%) with poor prognosis.The positive expression rate of PD-L1,CPEB4 and GRP in patients with poor prognosis was higher than that in prognosis group(P <0.05).Multivariate logistic regression analysis showed that PD-L1,CPEB4,and GRP were positive risk factors for poor prognosis in patients with glioma(B=2.535,2.164,2.373,95% Cl=1.513~105.257,1.764~42.973,1.274~90.311,both P <0.05).Conclusion The positive expression rate of PD-L1,CPEB4 and GRP in glioma tissues is increased,and it is related to WHO classification and KPS score,and affects the prognosis of patients.PD-L1,CPEB4 and GRP are detected in patients with glioma.Pathological grading and prognosis assessment are of great significance.