[1]涂曼,王平,何晓璞,等.慢性萎缩性胃炎伴肠上皮化生合并Hp感染患者胃黏膜组织PD-L1蛋白表达及其与抗Hp治疗效果的关系[J].陕西医学杂志,2026,(6):844-849.[doi:DOI:10.3969/j.issn.1000-7377.2026.06.021]
　TU Man,WANG Ping,HE Xiaopu,et al.Expression of PD-L1 protein in gastric mucosal tissues of patients with CAG accompanied by intestinal metaplasia and its relationship with therapeutic effect of anti-Hp[J].,2026,(6):844-849.[doi:DOI:10.3969/j.issn.1000-7377.2026.06.021]
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慢性萎缩性胃炎伴肠上皮化生合并Hp感染患者胃黏膜组织PD-L1蛋白表达及其与抗Hp治疗效果的关系

《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
期数:
2026年6期
页码:
844-849
栏目:
临床病理
出版日期:
2026-06-05

文章信息/Info

Title:
Expression of PD-L1 protein in gastric mucosal tissues of patients with CAG accompanied by intestinal metaplasia and its relationship with therapeutic effect of anti-Hp
作者:
涂曼1; 王平2; 何晓璞3; 华杰4; 魏睦新2
（1.南京医科大学第一临床医学院，江苏 南京 210029；2.南京医科大学第一附属医院中医科，江苏 南京 210029；3.南京医科大学第一附属医院老年医学科，江苏 南京 210029；4.南京医科大学第一附属医院消化内科，江苏 南京 210029）
Author(s):
TU Man1; WANG Ping2; HE Xiaopu3; HUA Jie4; WEI Muxin2
(1.The First Clinical Medical College of Nanjing Medical University，Nanjing 210029，China;2.Department of Traditional Chinese Medicine，the First Affiliated Hospital with Nanjing Medical University，Nanjing 210029，China;3.Department of Geriatrics，the First Affiliated Hospital with Nanjing Medical University，Nanjing 210029，China;4.Department of Gastroenterology，the First Affiliated Hospital with Nanjing Medical University，Nanjing 210029，China)
关键词:
慢性萎缩性胃炎; 肠上皮化生; 程序性细胞死亡蛋白配体-1; 幽门螺杆菌; 危险因素
Keywords:
Chronic atrophic gastritis; Intestinal metaplasia; Programmed cell death protein ligand-1; Helicobacter pylori; Risk factors
分类号:
R 573.3
DOI:
DOI:10.3969/j.issn.1000-7377.2026.06.021
文献标志码:
A
摘要:
目的：探讨慢性萎缩性胃炎（CAG）伴肠上皮化生患者胃黏膜组织中程序性细胞死亡蛋白配体-1（PD-L1）蛋白的表达，并分析其与抗幽门螺杆菌（Hp）治疗效果的关系。方法：前瞻性选取CAG伴肠上皮化生合并Hp感染患者199例为病例组，另同期选取健康体检且胃镜及病理检查无异常的志愿者180例为对照组。采集胃黏膜组织标本，分析病例组患者PD-L1蛋白表达与其临床特征的关系。病例组患者均给予为期14 d的标准四联疗法，比较治疗无效组与治疗有效组患者胃黏膜组织中PD-L1蛋白情况及临床资料，并分析影响CAG伴肠上皮化生患者治疗无效的因素。结果：病例组PD-L1蛋白阳性表达率高于对照组（P＜0.001）。在高倍显微镜下观察，可见阳性染色主要定位于细胞的细胞膜表面，呈散在分布；对照组中仅有极少数胃黏膜上皮细胞呈现PD-L1蛋白阳性染色；病例组中PD-L1蛋白阳性染色细胞的数量显著增多，且染色强度增强，细胞膜呈现出较深的棕黄色染色。PD-L1蛋白阳性表达组患者病情严重程度（中/重度）、病程≥3年占比高于阴性组（均P＜0.05）。199例CAG伴肠上皮化生患者经抗Hp治疗后，有38例患者Hp仍为阳性（治疗无效），161例Hp呈阴性（治疗有效）。治疗无效组患者胃黏膜组织PD-L1蛋白阳性表达率高于治疗有效组（P<0.05）。与治疗有效组比较，治疗无效组患者病情为中/重度、病程≥3年占比较高（均P＜0.05）。多因素回归分析结果显示，PD-L1蛋白阳性表达、病情为中/重度、病程≥3年为CAG伴肠上皮化生患者抗Hp治疗无效的危险因素（均P＜0.05）。结论：CAG伴肠上皮化生患者胃黏膜组织中PD-L1蛋白阳性表达率明显升高，且与抗Hp治疗效果有关。
Abstract:
Objective:To explore the expression of programmed cell death ligand-1 (PD-L1) protein in gastric mucosal tissues of patients with chronic atrophic gastritis (CAG) and intestinal metaplasia，and to analyze its relationship with anti-Helicobacter pylori (helicobacter pylori) The relationship between the therapeutic effect of Hp.Methods：A total of 199 patients with CAG accompanied by intestinal metaplasia combined Hp infection were prospectively selected as the case group.In addition，180 volunteers who had normal gastroscopy and pathological examination were selected as the control group during the same period.Gastric mucosal tissue specimens were collected，and the relationship between PD-L1 protein expression in the case group and their clinical characteristics was analyzed.All patients in the case group were given a standard quadruple therapy for 14 days.The PD-L1 protein conditions and clinical data of patients in the treatment ineffective group and the treatment effective group were compared，and the factors influencing the ineffective treatment of patients with CAG and intestinal metaplasia were analyzed.Results:The positive expression rate of PD-L1 protein in the case group was significantly higher than that in the control group (P<0.001).Under a high-power microscope，it can be seen that the positive staining was mainly localized on the cell membrane surface of the cell，showing a scattered distribution;in the control group，only a few gastric mucosal epithelial cells showed PD-L1 protein positive staining;in the case group，the number of PD-L1 protein positive staining cells was significantly increased，and the staining intensity was enhanced，and it can be seen that the cell membrane of these positive cells showed a deeper brown yellow staining.The severity of disease (moderate/severe) and the proportion of disease duration ≥3 years in the PD-L1 protein positive expression group were higher than those in the negative group (all P<0.05).Among 199 patients with CAG and intestinal metaplasia，38 patients were still Hp positive (treatment ineffective) and 161 patients were Hp negative (treatment effective) after anti-HP treatment.The positive expression rate of PD-L1 protein in gastric mucosa of the treatment ineffective group was higher than that of the treatment effective group (P<0.05).Compared with the treatment effective group，the proportion of patients with moderate/severe disease and disease duration ≥3 years in the treatment ineffective group was higher (all P<0.05).Multivariate regression analysis showed that the positive expression of PD-L1 protein，moderate/severe disease，and disease duration ≥3 years were the risk factors for the ineffective anti-Hp treatment in patients with CAG and intestinal metaplasia (all P<0.05).Conclusion:The positive expression rate of PD-L1 protein in gastric mucosa of CAG patients with intestinal metaplasia is significantly increased，which is related to the effect of anti-Hp treatment.

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[1]吴水清,李达周△,龚清全,等.福建宁德地区慢性萎缩性胃炎与幽门螺旋杆菌感染情况调查研究[J].陕西医学杂志,2020,49(6):763.[doi:DOI:10.3969/j.issn.10007377.2020.06.031]

备注/Memo

备注/Memo:
江苏省中医药科技发展计划项目（YB201983）
更新日期/Last Update: 2026-06-05