摘要
目的 探讨晚期非小细胞肺癌(NSCLC)患者外周血CD8+T淋巴细胞表面程序性死亡蛋白1(PD-1)表达情况,分析其与临床病理因素的相关性。方法 选取攀枝花市中心医院80例晚期NSCLC患者作为观察组,同期40例肺部良性疾病患者作为对照组。比较观察组和对照组及观察组不同临床特征患者CD8+T淋巴细胞表面PD-1表达率,分析CD8+T淋巴细胞表面PD-1表达率与临床特征的相关性,并将观察组根据治疗方案不同分为A组(化疗)、B组(化疗联合免疫治疗),各40例,对比2组疗效、不同疗效组治疗前后患者CD8+T淋巴细胞表面PD-1表达率、肿瘤相关物质[肿瘤相关物质群(TSGF)、糖类抗原125(CA125)、胸苷激酶(TK1)]水平,分析CD8+T淋巴细胞表面PD-1表达率与肿瘤相关物质相关性,随访1年,统计中位生存期(MST),对比不同生存期患者CD8+T淋巴细胞表面PD-1表达率及其对生存期的预测价值。结果 观察组CD8+T细胞表面PD-1表达率高于对照组(P<0.05);CD8+T淋巴细胞表面PD-1表达率与淋巴结转移、远处转移正相关(P<0.05);B组治疗总有效率(90%)高于A组(80%),但差异无统计学意义(P>0.05);随疗效降低,治疗前、治疗6周后不同疗效患者CD8+T淋巴细胞表面PD-1表达率、血清TSGF、CA125、TK1水平呈升高趋势(P<0.05);治疗前后CD8+T淋巴细胞表面PD-1表达率与血清TSGF、CA125、TK1水平正相关(P<0.05);生存期>MST患者治疗前、治疗6周后CD8+T淋巴细胞表面PD-1表达率低于生存期≤MST患者(P<0.05);治疗前CD8+T淋巴细胞表面PD-1表达率预测预后生存的曲线下面积(AUC)值为0.766,当截断值=16.64%时,敏感度为89.49%,特异度为60.53%;治疗6周后CD8+T淋巴细胞表面PD-1表达率预测预后生存的AUC值为0.811,当截断值=16.11%时,敏感度为89.47%,特异度为60.53%。结论 晚期NSCLC患者外周血CD8+T淋巴细胞表面PD-1表达升高,且与淋巴结转移、远处转移、疗效及生存期有关,可作为临床评估病情、疗效及预后的辅助指标。
Objective To investigate the expression of programmed cell death protein 1(PD-1) on the surface of CD8+T cells in the patients with advanced non-small cell lung cancer(NSCLC),and to determine its correlation with clinicopathological factors.Methods Eighty patients with advanced NSCLC admitted to Panzhihua Municipal Central hospital were included as the study group,and a contemporary cohort of 40 patients with benign lung diseases were included as the control group.The expression rate of PD-1 on the surface of CD8+T cells was compared between the two groups and among the patients with different clinicopathological factors in the study group.The correlation between the expression rate of PD-1 on the surface of CD8+T cells and the clinical pathological factors was determined.The study group was divided into groups A(chemotherapy) and group B(chemotherapy+immunotherapy) according to treatment protocols(n=40 each).The efficacy,the expression rate of PD-1 on the surface of CD8+T cells and the levels of tumor-related substances [tumor specific growth factor(TS-GF),carbohydrate antigen(CA125) and thymidine kinase(TK1)] in the patients with different curative effects at baseline and after the treatment were compared between the two groups.The correlation between the expression rate of PD-1 on the surface of CD8+T cells and tumor-related substances was determined.All patients were fol-lowed up for 1 year,and the median survival time(MST) was counted.The expression rate of PD-1 on the surface of CD8+T cells in patients with different survival times and its predictive value for survival time were compared.Results The expression rate of PD-1 on the surface of CD8+T cells in the study group was higher than that in the control group(P<0.05).With the decrease of curative effect,the expression rate of PD-1 on the surface of CD8+T cells and the serum levels of TS-GF,CA125 and TK1 in the patients with different curative effects at baseline and at 6 weeks after the treatment showed an increasing trend(PMST was lower than that in patients with survival time≤MST at baseline and at 6 weeks after the treatment(P<0.05).The prognostic survival AUC value was 0.766 predicted by the expression rate of PD-1 on the surface of CD8+T cells at baseline,and the sensitivity was 89.49% and the specificity was 60.53% when the Cutoff value=16.64%.The prognostic survival AUC value was 0.811 predicted by the expression rate of PD-1 on the surface of CD8+T cells at 6 weeks after the treatment,and the sensitivity was 89.47% and the specificity was 60.53% when the Cutoff value=16.11%.Conclusion The expression of PD-1 on the surface of CD8+T cells in patients with advanced NSCLC is elevated,and it is related to lymph node metastasis,distant metastasis,efficacy and survival time.It may be used as an auxiliary indicator for clinical evaluation of disease status,efficacy and prognosis.
作者
彭明尧
周雪宇
蒋利华
周国旗
陈建新
Peng Mingyao;Zhou Xueyu;Jiang Lihua;Zhou Guoqi;Chen Jianxin(Department of Oncology and Hematology,Panzhihua Municipal Central Hospital,Sichuan 617000,China)
出处
《中国药物与临床》
CAS
2022年第7期590-595,共6页
Chinese Remedies & Clinics
基金
四川省科技计划项目(2018JDR2377)。
