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结直肠癌肝转移灶中PD-L1基因阳性患者肝切除后的预后相关因素

Prognosis-related Factors of Colorectal Cancer Patients with Positive PD-L1 Expression in Liver Metastases After Hepatectomy

  • 摘要:
    目的 探讨直肠癌肝转移灶中PD-L1基因阳性患者肝切除术后预后的相关因素。
    方法 回顾性分析68例以手术为主的个体化综合治疗结直肠癌肝转移灶中PD-L1基因阳性患者的临床资料,观察手术治疗后疗效及预后,分析相关因素。
    结果 单因素分析结果显示:无放疗、N分期、RAS基因突变状态、T分期、MMR表达缺失(dMMR)和Duck分期、肝转移灶最长径及肝转移间隔 < 1年差异有统计学意义(均P < 0.05)。多因素分析显示:无dMMR(P=0.012)、Duck分期A(P=0.000)、肝转移间隔 > 1年(P=0.020)及肝转移灶最长径(P=0.006)为影响直肠癌肝转移灶中PD-L1基因阳性患者术后预后的保护因素。
    结论 直肠癌肝转移灶中PD-L1基因阳性患者的有效治疗仍是手术为主的个体化综合治疗,无dMMR、Duck分期A、肝转移间隔 > 1年及肝转移灶最长径≤5 cm是术后生存的保护因素。

     

    Abstract:
    Objective To evaluate the prognosis-related factors of colorectal cancer patients with positive PD-L1 expression in liver metastases after hepatectomy.
    Methods We reviewed retrospectively the clinical data of 68 colorectal cancer patients with positive PD-L1 expression in liver metastases receiving personalized comprehensive treatment which was mainly consisted of surgical resection. We observed the results and prognosis after surgical resection and analyzed related factors.
    Results Univariate analysis showed that no radiotherapy, N stage, RAS mutation status, T stage, dMMR, Duck stage, disease free interval from primary to metastases≤12 months and largest hepatic tumor diameter > 5 cm had obvious significance (all P < 0.05). Multivariate logistic analysis regression revealed that without dMMR (P=0.012), Duck A stage (P=0.000), disease free interval from primary to metastases > 12 months (P=0.020) and largest hepatic tumor diameter < 5 cm (P=0.006) were independent protective factors for the prognosis of colorectal cancer patients with positive PD-L1 expression in liver metastases after surgical resection.
    Conclusion Personalized comprehensive treatment which is mainly consisted of surgical resection still has a good effect on colorectal cancer patients with positive PD-L1 expression in liver metastases after hepatectomy. Without dMMR, Duck A stage, disease free interval from primary to metastases > 12 months and largest hepatic tumor diameter ≤5cm are independent protective factors for patients' prognosis.

     

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