上海交通大学学报（医学版）

上海交通大学学报（医学版） ›› 2019, Vol. 39 ›› Issue (8): 881-.doi: 10.3969/j.issn.1674-8115.2019.08.012

• 论著·临床研究 • 上一篇    下一篇

程序性细胞死亡蛋白 1配体 2在激光共聚焦显微内镜诊断 结直肠癌中应用的初步探索

张昕恬，陈锦南，王奇雯，李晓波   

  1. 上海交通大学医学院附属仁济医院消化病研究所，上海 200001
  • 出版日期:2019-08-28 发布日期:2019-09-23
  • 通讯作者: 李晓波，电子信箱：lixiaobo@renji.com。
  • 作者简介:张昕恬（1993—），女，硕士生；电子信箱： zxtxxsc8@sjtu.edu.cn。
  • 基金资助:
    上海自然科学基金（16ZR1420400）

Preliminary study on application of programmed cell death 1 ligand 2 to the diagnosis of colorectal cancer in confocal laser endomicroscopy

ZHANG Xin-tian, CHEN Jin-nan, WANG Qi-wen, LI Xiao-bo   

  1. Institute of Digestive Diseases, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200001, China
  • Online:2019-08-28 Published:2019-09-23
  • Supported by:
    Natural Science Foundation of Shanghai, 16ZR1420400

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摘要： 目的 ·研究程序性细胞死亡蛋白 1配体 2（programmed cell death 1 ligand 2，PD-L2）在结直肠癌组织中的表达情况与患者预后之间的关系，探究 PD-L2联合激光共聚焦显微内镜诊断结直肠癌的可行性。方法 ·采用免疫组织化学法检测 100例结直肠癌患者手术切除标本 PD-L2表达情况，分析其表达差异和患者预后之间的关系；采用免疫组织化学法和 Western blotting检测 30例早期结直肠癌和癌旁正常黏膜 PD-L2表达情况，分析其表达差异；采用激光共聚焦显微内镜观察经 PD-L2荧光抗体孵育后的离体早期结直肠癌和癌旁正常黏膜组织荧光强弱的差异。结果 · PD-L2低表达和高表达患者在病灶 T分期和远处转移方面的差异具有统计学意义，且 PD-L2表达水平的高低与 T分期、远处转移均呈正相关关系（ r0.274，P0.009；r0.216，P0.039）；PD-L2膜表达强弱与病灶 T分期之间也呈正相关（ r0.201，P0.037）。生存分析表明， PD-L2高表达患者的存活率显著低于 PD-L2低表达患者（ P0.000）。 PD-L2在早期结直肠癌中蛋白表达显著高于癌旁正常肠黏膜；激光共聚焦显微内镜下，早期结直肠癌的荧光强度高于癌旁正常黏膜。结论 ·结直肠癌中 PD-L2高表达预示了患者的不良预后，PD-L2联合激光共聚焦显微内镜可能有助于结直肠癌的诊断。

关键词: 程序性细胞死亡蛋白 1配体 2, 激光共聚焦显微内镜, 结直肠癌, 诊断

Abstract:

Objective · To investigate the relationship between of programmed cell death 1 ligand 2 (PD-L2) in colorectal cancer and prognosis, and explore the feasibility of application of PD-L2 in confocal laser endomicroscopy in the diagnosis of colorectal cancer. Methods · Immunohistochemistry was used to detect the of PD-L2 in 100 patients with colorectal cancer. The relationship between the levels and the prognosis of patients was analyzed. The s of PD-L2 in 30 cases of early colorectal cancer and adjacent normal mucosa were detectedimmunohistochemistry and Western blotting. Confocal laser endomicroscopy was used to observe the difference in fluorescence intensity between early colorectal cancer and adjacent normal mucosa after being incubated with PD-L2 fluorescent antibody. Results · There were statistically significant differences in T-stage and distant metastasis between the patients with low and high of PD-L2, and they were both positively correlated with of PD-L2 (r0.274, P0.009; r0.216, P0.039). There was also a positive correlation between PD-L2 membrane and T stage (r0.201, P0.037). Survival analysis showed that the survival rate of patients with high PD-L2 was significantly lower than that of patients with low PD-L2 (P0.000). The protein of PD-L2 in early colorectal cancer was significantly higher than that in adjacent normal mucosa. Under confocal laser endomicroscopy, the fluorescence intensity of early colorectal cancer was higher than that of adjacent normal mucosa. Conclusion · High of PD-L2 in colorectal cancer predicts poor prognosis in patients. Application of PD-L2 in confocal laser endomicroscopy may contribute to the diagnosis of colorectal cancer.

Key words: programmed cell death 1 ligand 2, confocal laser endomicroscopy, colorectal cancer, diagnosis

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