摘要
目的研究CD3^(+)T细胞比例、白介素-8(IL-8)与表皮生长因子受体(EGFR)突变进展期非小细胞肺癌(NSCLC)患者表皮生长因子受体酪氨酸激酶抑制剂(EGFR-TKI)靶向治疗应答的相关性及治疗前的预测价值。方法选取2022年5月至2024年6月许昌市中心医院收治的196例EGFR突变进展期NSCLC患者,根据EGFR-TKI靶向治疗应答情况分为有效组(n=103)和非有效组(n=93)。比较两组患者的基线资料、CD3^(+)T细胞比例、IL-8,采用Spearman分析CD3^(+)T细胞比例、IL-8与治疗应答的相关性,采用Logistic回归分析EGFR-TKI靶向治疗应答的影响因素,采用受试者工作特征(ROC)曲线及曲线下面积(AUC)分析CD3^(+)T细胞比例、IL-8对EGFR-TKI靶向治疗应答的预测价值。结果非有效组和有效组患者的Ⅳ期分期(81.72%vs 52.43%)、中高分化程度(68.82%vs 81.55%)、转移器官数量≥2个(44.09%vs 24.27%)比较,差异均有统计学意义(P<0.05);非有效组患者的CD3^(+)T细胞比例为(66.83±9.04)%,明显低于有效组的(73.52±6.11)%,IL-8为(21.56±6.27)ng/L,明显高于有效组的(13.92±4.58)ng/L差异均有统计学意义(P<0.05);Spearman分析结果显示,CD3^(+)T细胞比例与治疗应答呈负相关(r=-0.722,P<0.05),IL-8与治疗应答呈正相关(r=0.710,P<0.05);校正分期、分化程度等因素前后,Logistic回归分析结果显示,CD3^(+)T细胞比例、IL-8仍是EGFR-TKI靶向治疗应答的影响因素(P<0.05);ROC结果显示,常规因素(分期、分化程度、转移器官数量)联合预测患者EGFR-TKI靶向治疗应答的AUC值为0.858,新型因素(CD3^(+)T细胞比例、IL-8)联合预测的AUC值为0.924,新型因素联合预测的AUC显著大于常规因素联合(Z=2.060,P=0.039)。结论CD3^(+)T细胞比例、IL-8与EGFR突变进展期NSCLC患者EGFR-TKI靶向治疗应答密切相关,两者在评估EGFR-TKI靶向治疗应答方面具有良好的预测效能。
Objective To investigate the correlation of CD3^(+)T-cell proportion and interleukin-8(IL-8)with the response to epidermal growth factor receptor-tyrosine kinase inhibitor(EGFR-TKI)targeted therapy in patients with advanced EGFR-mutant non-small cell lung cancer(NSCLC),and to evaluate their predictive value before treatment.Methods A total of 196 patients with advanced EGFR-mutant NSCLC admitted to Xuchang Central Hospital from May 2022 to June 2024 were selected.Based on their response to EGFR-TKI targeted therapy,they were divided into an effective group(n=103)and a non-effective group(n=93).Baseline data,CD3^(+)T-cell proportion,and IL-8 levels were compared between the two groups.Spearman analysis was used to assess the correlation of CD3^(+)T-cell proportion and IL-8 with treatment response.Logistic regression was used to analyze factors influencing the response to EGFR-TKI targeted therapy.Receiver operating characteristic(ROC)curves and the area under the curve(AUC)were used to evaluate the predictive value of CD3^(+)T-cell proportion and IL-8 for the response to EGFR-TKI targeted therapy.Results Statistically significant differences were observed between the non-effective and effective groups in terms of stageⅣ(81.72%vs 52.43%),moderate/high differentiation(68.82%vs 81.55%),and number of metastatic organs≥2(44.09%vs 24.27%),all P<0.05.The CD3^(+)T-cell proportion in the non-effective group was significantly lower than that in the effective group:(66.83±9.04)%vs(73.52%±6.11)%;the IL-8 level was significantly higher:(21.56±6.27)ng/L vs(13.92±4.58 ng/L);the differences were statistically significant(both P<0.05).Spearman analysis showed that CD3^(+)T-cell proportion was negatively correlated with treatment response(r=-0.722,P<0.05),while IL-8 was positively correlated(r=0.710,P<0.05).Logistic regression analysis,both before and after adjusting for factors such as stage and differentiation degree,indicated that CD3^(+)T-cell proportion and IL-8 remained significant factors influencing the response to EGFR-TKI targeted therapy(P<0.05).ROC curve analysis showed that the AUC for predicting response using conventional factors(stage,differentiation degree,number of metastatic organs)combined was 0.858,while the AUC for the novel factors(CD3^(+)T-cell proportion,IL-8)combined was 0.924.The AUC for the novel factors combined was significantly greater than that for the conventional factors combined(Z=2.060,P=0.039).Conclusion CD3^(+)T-cell proportion and IL-8 are closely associated with the response to EGFR-TKI targeted therapy in patients with advanced EGFR-mutant NSCLC.Both demonstrate good predictive performance for assessing the response to EGFR-TKI targeted therapy.
作者
尹钊
刘志
訾滢洁
王鹏远
YIN Zhao;LIU Zhi;ZI Ying-jie;WANG Peng-yuan(Department of Oncology,Xuchang Central Hospital,Xuchang 461000,Henan,CHINA)
出处
《海南医学》
2025年第24期3589-3594,共6页
Hainan Medical Journal
基金
2024年度河南省许昌市重点研发与推广专项(科技攻关)备案项目(编号:2024030)。
