| 摘要: |
| ［摘要］ 目的 分析血清可溶性CD73（sCD73）、S100钙结合蛋白A8/A9（S100A8/A9）与晚期子宫内膜癌患者临床病理特征及程序性死亡受体-1（PD-1）/程序性死亡配体1（PD-L1）抑制剂治疗预后的关联性。方法 招募2020年3月至2021年2月于齐齐哈尔市第一医院接受PD-1/PD-L1抑制剂治疗的晚期子宫内膜癌患者142例，入院后于晨间采集空腹肘部静脉血5 mL，取血清，采用酶联免疫吸附法测定患者血清sCD73、S100A8/A9水平。在随访期间，有58例患者死亡（死亡组），84例存活（存活组）。采用受试者工作特征（ROC）曲线评估血清sCD73、S100A8/A9水平预测患者生存结局的效能。根据ROC曲线分析的最佳截断值将患者分为sCD73高表达组、sCD73低表达组以及S100A8/A9高表达组、S100A8/A9低表达组。采用Cox回归分析影响PD-1/PD-L1抑制剂治疗晚期子宫内膜癌生存预后的因素。分析血清sCD73、S100A8/A9表达水平与患者临床病理特征的关联性。结果 存活组血清sCD73、S100A8/A9水平低于死亡组，差异有统计学意义（P<0.05）。ROC曲线分析结果显示，血清sCD73、S100A8/A9均能有效预测PD-1/PD-L1抑制剂治疗晚期子宫内膜癌患者的生存结局（P<0.05），其最佳截断值分别为5.30 μg/L、3.06 μg/mL。sCD73、S100A8/A9低表达组的生存预后均优于其高表达组（log-rank检验： χ2=91.367，P<0.001； χ2=69.852，P<0.001）。多因素Cox回归分析结果显示，较高的血清sCD73［HR(95%CI)=2.511（1.497～4.214），P<0.001］、S100A8/A9［HR(95%CI)=1.806（1.106～2.948），P=0.018］水平是患者生存预后不良的独立危险因素。sCD73、S100A8/A9高表达组低分化程度占比显著大于其低表达组（P<0.05）。结论 晚期子宫内膜癌患者血清sCD73、S100A8/A9高水平可能提示其肿瘤分化程度低，是PD-1/PD-L1抑制剂治疗患者生存预后不良的危险因素。 |
| 关键词: 晚期子宫内膜癌 程序性死亡受体-1/程序性死亡配体1抑制剂 可溶性CD73 S100钙结合蛋白A8/A9 病理特征 生存预后 |
| DOI：10.3969/j.issn.1674-3806.2024.09.17 |
| 分类号: |
| 基金项目:黑龙江省自然科学基金联合引导项目（编号：A20220440） |
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| Analysis on the correlation of serum sCD73 and S100A8/A9 levels with clinicopathological features and therapeutic prognosis of PD-1/PD-L1 inhibitors in patients with advanced endometrial cancer |
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JIA Tianhan1, SHAO Kai2, YANG Fan3, CAI Yujie1, YANG Liyuan1
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1.Department of Gynaecology, the First Hospital of Qiqihar, Heilongjiang 161005, China; 2.Department of Pharmacy, the First Hospital of Qiqihar, Heilongjiang 161005, China; 3.Clinicopathological Diagnostic Center, Qiqihar Medical University, Heilongjiang 161006, China
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| Abstract: |
| ［Abstract］ Objective To analyze the correlation of serum soluble CD73(sCD73) and S100 calcium-binding proteins A8/A9(S100A8/A9) levels with clinicopathological features and therapeutic prognosis of programmed death receptor-1(PD-1)/programmed death-ligand 1(PD-L1) inhibitors in patients with advanced endometrial cancer. Methods A total of 142 patients with advanced endometrial cancer who were treated with PD-1/PD-L1 inhibitors in the First Hospital of Qiqihar from March 2020 to February 2021 were recruited. A total of 5 mL of fasting elbow venous blood was collected from the patients in the morning after admission and their blood serum were collected, and the patients′ serum levels of sCD73 and S100A8/A9 were detected by using enzyme-linked immunosorbent assay(ELISA). During the follow-up period, 58 patients died(death group) and 84 patients survived(survival group). The efficacy of serum sCD73 and S100A8/A9 levels in predicting the patients′ survival outcomes were evaluated by using receiver operating characteristic(ROC) curve. According to the optimal cut-off values of the ROC curve analysis, the patients were divided into sCD73 high expression group, sCD73 low expression group, S100A8/A9 high expression group and S100A8/A9 low expression group. The factors affecting the survival prognosis of the advanced endometrial cancer patients treated with PD-1/PD-L1 inhibitors were analyzed by using Cox regression. The correlation of serum sCD73 and S100A8/A9 expression levels with the patients′ clinicopathological features were analyzed. Results The serum levels of sCD73 and S100A8/A9 in the survival group were lower than those in the death group, and the differences were statistically significant(P<0.05). The results of ROC curve analysis showed that serum sCD73 and S100A8/A9 could effectively predict the survival outcomes of the advanced endometrial cancer patients treated with PD-1/PD-L1 inhibitors(P<0.05), and the optimal cut-off values were 5.30 μg/L and 3.06 μg/mL, respectively. The survival prognosis in the sCD73 low expression group and the S100A8/A9 low expression group was better than that in the sCD73 high expression group and the S100A8/A9 high expression group, respectively(log-rank test: χ2=91.367, P<0.001; χ2=69.852, P<0.001). The results of multivariate Cox regression analysis showed that higher serum levels of sCD73［HR(95%CI)=2.511(1.497-4.214), P<0.001］ and S100A8/A9［HR(95%CI)=1.806(1.106-2.948), P=0.018］ were independent risk factors for poor survival prognosis in the patients. The proportions of poor differentiation in the sCD73 high expression group and the S100A8/A9 high expression group were significantly greater than those in the sCD73 low expression group and the S100A8/A9 low expression group, respectively(P<0.05). Conclusion High levels of serum sCD73 and S100A8/A9 in the patients with advanced endometrial cancer may indicate poor tumor differentiation and are risk factors for poor survival prognosis in the patients treated with PD-1/PD-L1 inhibitors. |
Key words: Advanced endometrial cancer Programmed death receptor-1(PD-1)/programmed death-ligand 1(PD-L1) inhibitor Soluble CD73(sCD73) S100 calcium-binding proteins A8/A9(S100A8/A9)
Pathological feature Survival prognosis |
