Multiple Factor Analysis Of Tumor Budding Andclinicpathologic Features And Expression Of PD-1/PDL-1 Protein In Colorectal Cancer

ObjectiveColorectal cancer is a common malignant tumor in gastrointestinal tract.In recent 20 years in China,especially in large cities,the incidence of disease has increased significantly.Some studies show that tumor budding is related to invasion,metastasis and prognosis,and the expression of PD-1/PDL-1 affects the prognosis of colorectal cancer.However,the relationship between tumor budding and clinicopathologic features and the expression of PD-1/PD-L1 in colorectal cancer has not been reported.In order to provide the experimental basis for the research of colorectal cancer,the multiple factor analysis of tumor budding and clinicopathological features and the expression of PD-1/PDL-1 protein were retrospectively studied.MethodsBetween 2014 and October 30,2020,210 patients underwent radical colorectal cancer surgery at the Chifeng Cancer Hospital.The tumor budding was evaluated by HE staining,and the expression of PD-1 and PDL-1 protein in the non-budding and budding region was detected by IHC.To analyze the relationship between the expression of PD-1/PDL-1 protein and non-budding and budding in colorectal cancer.SPSS24.0 statistical software was used to analyze the data of the relationship between tumor budding and clinicopathologic features of patients with colorectal cancer.Chi-square Fisher exact probability method was used to analyze the classified variables,multi-factor logistic regression was used to study the influence of multiple variables on outcome indexes,independent risk factors were studied,and ROC curve was used to evaluate the accuracy of logistic regression model.P≪0.05 had statistical significance.ResultsAmong the 210 patients with rectal cancer,50 had low budding,81 had high budding,and 79 had no budding.The budding rate was 62.38%.PD-1 and PDL-1 proteins were not stained or were less than 1%stained by immunohistochemistry.PD-L was expressed in the infiltrating lymphocyte of Tumor Stroma.The number of positive cells in the focal area was less than 5%,which was negative.The parameters that affected the height and height of budding were the gross shape,pathological stage,depth of intestinal wall invasion and metastasis(P≪0.05),and the patient’s age,sex,tumor location,tumor size and histology,there was no correlation between the height of the tumor and the size of the Tumor(P>0.05).The gross shape,pathological stage and depth of intestinal wall invasion of the tumor were the variables that influenced the height and depth of budding.The relative risk was 2.158,2.41 and 1.598,respectively.Pathological stage is the most important independent risk factor,that is,increased by one unit,the risk of colorectal cancer budding increased about 2.4 times.The area of the ROC curve is 0.767,and the 95 confidence interval is 0.680-0.853,which shows that the multi-factor logistic regression has good accuracy.Conclusions1.The expression of PD-1/PDL-1 protein was not significantly associated with non-budding and budding of colorectal cancer cells.2.Univariate analysis showed that the gross shape,pathological stage,depth of intestinal wall invasion and metastasis of the tumor were the main factors influencing the budding rate of the patients(P≪0.05),there was no correlation between the height of the tumor and the size of the Tumor(P>0.05).3.Multivariate analysis showed that the gross morphology,pathological stage and the depth of intestinal wall invasion were the most important independent risk factors,and the relative risk was 2.158,2.41 and 1.598,respectively,Pathological stage is the most important independent risk factor,that is,increased by one unit,the risk of colorectal cancer budding increased about 2.4 times.4.The area of the ROC curve is 0.767,and the 95 confidence interval is 0.680-0.853,which shows that the multifactor logistic regression has good accuracy.