不同检测策略在预测非小细胞肺癌的PD1/PD-L1抑制剂临床疗效中的应用  

Application of Different Detection Strategies in Predicting the Clinical Outcome of PD-1/PD-L1 Inhibitors in Non-small Cell Lung Cancer

作　　者：董艳 吴媚 DONG Yan;WU Mei(Laboratory Department,The First People's Hospital of Jiangxia District,Wuhan 430000,China;Laboratory of Clinical Microbiology,Testing School,Hubei University of Chinese Medicine,Wuhan 430065,China)

机构地区：[1]武汉市江夏区第一人民医院检验科,武汉430000 [2]湖北中医药大学检验学院临床微生物学教研室,武汉430065

出　　处：《中国生物化学与分子生物学报》2019年第2期131-139,共9页Chinese Journal of Biochemistry and Molecular Biology

摘　　要：近10年来,程序性死亡因子1(programmed death-1,PD-1)及其配体(programmed death ligand-1,PD-L1)的抑制剂在非小细胞肺癌(non-small cell lung cancer,NSCLC)的临床治疗中取得了重大突破,有望改变晚期NSCLC的治疗方式。然而,PD-1/PD-L1抑制剂在对NSCLC的治疗中需要借助有效的生物标志物以寻找受益人群(约20%～40%)。目前,临床上主要的判断标准是PD-L1的表达水平。本文综述了近年来在NSCLC中,与预测PD-1/PD-L1抑制剂疗效的PD-L1表达相关的检测方法,包括免疫组化、基于DNA/RNA水平检测、可溶性PD-L1的检测、正电子发射断层显像(positron emission tomography,PET)技术、多重免疫组化技术、流式细胞术和液体活检技术等,着重探讨了不同检测策略在评价PD-L1表达上的最新进展及应用前景,从而推动其在NSCLC免疫治疗中的临床应用。The last decade has witnessed great breakthroughs for the inhibitors of programmed death-1/programmed death ligand-1( PD-1/PD-L1) in non-small cell lung cancer( NSCLC), which was expected to improve the treatment for advanced NSCLC patients. The problem facing the clinical application of the inhibitors is finding potent biomarkers for outcome prediction,so far,the levels of PDL1 expression remain the main criteria. This review summarized the current progress on the detection of PD-L1 expression which was helpful in predicting clinical outcome of PD-1/PD-L1 inhibitors in advanced NSCLC,including immunohistochemistry( IHC),detection on DNA/RNA levels,detection of soluble PD-L1,positron emission tomography( PET),multiple IHC,flow cytometry,and liquid biopsy technique. Meanwhile,we discussed multiple strategies to optimize the evaluation of PD-L1 expression in this field to aid the clinical application of immunotherapy in NSCLC.

关 键 词：非小细胞肺癌 程序性死亡因子1/程序性死亡因子1配体(PD-1/PD—L1)抑制剂 PD—L1表达水平的检测 

分 类 号：R4[医药卫生—临床医学] R9