Research Of The Relationship Between Expression Of PD-L1 And CD68 And High Risk And Prognosis Of Epithelial Ovarian Cancer

Research background Ovarian cancer is one of the three most common malignant tumors in the female reproductive system,as well as one tumor with highest malignancy,besides,the incidence of ovarian cancer is merely behind cervical cancer and endometrial carcinoma.However,more than 70% patients had advanced stage and poor prognosis,and the five-year survival rate was only aroud 30%,due to its hidden incidence,lack of obvious early clinical symptoms and signs,and easy to metastasize and spread widely.Therefore,the mortality rate of ovarian cancer ranked in the first among gynecologic malignant tumors,which posed serious threat to the life and health of women.In recent years,the majority of medical workers have made a lot of efforts in improving standardization therapy,operation methods,radiotherapy and chemotherapy programs of ovarian cancer.With the development of molecular genetics and the deepening of understanding of changing patterns,parting and cell source,targeted therapy of ovarian cancer has been developing continuously,but the overall survival rate had no notable improvement clinically.Research shows that clinical stages,histological type,cell differentiation grade,cancer size,surgical clearance and lymphatic metastasis are main factors influencing prognosis of ovarian cancer patients.Unfortunately,these indicators could not completely and accurately forecast prognosis of all ovarian cancer patients,therefore,further seeking of more accurate prognosis factors to guide clinical therapy is of high importance.Early diagnosis and effective therapeutic measures have become research hotspots at present,so it is urgent to find tumor biomarker with diagnostic value,strong specificity and high sensitivity,in order to provide new thought for the therapy of ovarian cancer,which has extremely important clinical and practical significance for prognosis improvement of ovarian cancer patients.As is known,tumor tissue and surrounding infiltrating macrophages are called as tumor-associated macrophages,research shows that multiple immune cells gather and participate in tumor immunology in tumor microenvironment,among these cells, tumor-associated macrophages count most.Tumor-associated macrophages could generate and release cell factors and growth factors under certain microenvironment function to participate in the formation of tumor microvessel,which has immune suppression,escape effect and other functions,for this reason,it could promote development and transfer of tumor,tumor-associated macrophages with multiple intraplastic infiltration are indicators of bad prognosis.However,CD68 is a kind of glycoprotein and the important molecule of surface expression of tumor-associated macrophages,as well as the key character of expression of tumor-associated macrophages.B7 molecular family is a group of costimulatory molecules which has been widely researched in recent years,they provide the second signal of T-cell activation and antitumor immunity of mediated body,which have significant meaning in tumor occurrence,tumor progression and gene therapy.The expression of immune costimulatory molecules from B7 molecular family is the extremely important character in TME.PD-L1 is part of programmed death receptor-1(Programmed death 1,PD-1),and cell surface type I transmembrane protein of B7 family,besides,it is the popular immune negative regulatory molecule in past few years,which is also called as Immune Checkpoint.PD-1 expressed on the surface of tumor cells could connect with PD-1 expressed on the surface on T cells in tumor microenvironment,which could decrease tumor-specific T cell activity or inactivate T cells,block immune response,induce immune escape of tumor cells,weaken immune function of the body,which could not attack and kill tumor cells.Besides traditional operation,chemotherapy and radiotherapy methods for therapy of malignant ovarian tumor,researchers have been actively exploring new directions at present,such as research of Bevacizumab and other target drug.Moreover,blocking of PD-1/PD-L1 pass is also one of the most popular research direction.Research purpose To investigate expression of PD-L1 and CD68 molecules in epithelial ovarian cancer and benign cyst tissue through immunohistochemical method,and the relationship between the expression and overall survival of patients,and to explore relationship between the expression of PD-L1 and CD68 molecules and high risk and clinical prognosis of epithelial ovarian cancer patients,in order to provide new direction for high risk assessment,prognosis assessment and clinical therapeutic schedule choice of epithelial ovarian cancer.Research population and method 71 cases of EOC patients treated in Jiansu Taizhou People's Hospital from January 2010 to July 2017,with complete clinical data,excision operation and pathology confirmation,and complete follow-up records and 8 cases of benign ovarian cyst were adopted.The research detects the expression of PD-L1 and CD68 molecules in ovarian cancer tissue and benign cyst tissue through immunohistochemical method,and follow-up all patients for 1 to 7 years,the interval time of follow-up year is 6-month.Research results 1.Relationship between expression of PD-L1 and clinicopathological parameters in EOC tissue.The results showed that the expression level of PD-L1 in different parts of EOC tissue cell membrane and cytoplasm was not correlated with FIGO stage and pathological type(P>0.05),and not correlated with histological type of ovarian cancer(P>0.05),but correlated with differentiation degree of tumor tissue,the expression level of PD-L1 molecule in low differentiation group was higher than that in middle and high differentiation group(P<0.05).2.Relationship between PD-L1 expression and clinical age in epithelial ovarian cancer tissue.According to the median age of 51,the patients were divided into two groups: ?51 years old and >51 years old group.There was no difference in the expression of PD-L1 molecules in EOC tissue cell membrane and cytoplasm between?51 years old and >51 years old groups.3.Expression of CD68 in EOC tissue and benign cyst tissue.Immunohistochemical results showed that few CD68 positive cells were found in benign ovarian tissues,with 2 cases of no expression and 6 cases of low expression;in EOC tissue,the positive staining products of CD68 were diffused or scattered brown or brown granules,with 16 cases of low expression and 55 cases of moderate and high expression.4.Expression of PD-L1 in EOC tissue and benign cyst tissue.Immunohistochemical results showed that no PD-L1 positive cells were found in benign ovarian tissues,and the positive staining products of PD-L1 were diffused or scattered brown or brown granules in EOC tissue.There were 17 cases of PD-L1 molecule expression in cancer cell membrane and 22 cases of PD-L1 molecule expression in cancer cell cytoplasm among total 71 EOC tissues.5.Relation between CD68 and PD-L1 molecules and prognosis survival years of EOC patients.There was no positive correlation between the expression level of CD68 molecule and the survival years of EOC patients(P>0.05),and a negative correlation between the expression level of PD-L1 molecule and the survival years of EOC patients(P<0.05).Conclusion: Research results show that the expression of CD68 and PD-L1 could be used as the index to evaluate the high risk of EOC,and PD-L1 could be used as an important clinical prognostic indicator for EOC patients at the same time.