程序性死亡配体-1表达对I期肺腺癌术后患者预后的价值  

Predictive value of programmed death ligand-1 on postoperative stage I lung adenocarcinoma

作　　者：肖鹏[1] 张晓[1] 靳超[1] Peng Xiao;Xiao Zhang;Chao Jin(Luoyang Central Hospital Affiliated to Zhengzhou University,Luoyang,Henan 471009,China)

机构地区：[1]郑州大学附属洛阳市中心医院,河南洛阳471009

出　　处：《中国现代医学杂志》2018年第27期45-52,共8页China Journal of Modern Medicine

摘　　要：目的探究程序性死亡配体-1(PD-L1)表达对Ⅰ期肺腺癌肺叶切除联合系统性淋巴结清扫术后患者预后的价值。方法收集86例经电视胸腔镜下肺叶切除联合系统性淋巴结清扫术的I期浸润性肺腺癌的患者,检测其血清中可溶性程序性死亡配体-1(s PD-L1),分析s PD-L1对术后复发及生存的预测价值。结果 sPD-L1高表达胸膜受累、术后ECOG评分、分化程度、临床分期、病理类型及GGO状态具有相关性(P <0.05)。s PD-L1对术后复发诊断的曲线下面积AUC为0.730(95%CI:0.671,0.876),对术后生存诊断的AUC为0.771(95%CI:0.685,0.907)。Cox风险比例模型分析显示,ECOG评分、PD-L1、分化程度、临床分期、GGO状态及胸膜受累为术后预后的影响因素。结论 sPD-L1高表达为I期肺腺癌患者经电视胸腔镜肺叶切除联合系统淋巴结清扫术后复发、预后生存的危险因素。Objective To investigate the prognostic value of programmed death ligand 1(PD-L1)in patients with stage I lung adenocarcinoma post lobectomy combined with systemic lymphadenectomy.Methods A total of 86 patients with stage I infiltrating lung adenocarcinoma undergoing thoracoscopic lobectomy combined with systemic lymphadenectomy were enrolled in this study.Serum PD-L1(sPD-L1)was measured.Association of PD-L1and clinical characteristics was identified.Results Concentration of sPD-L1 was significantly correlated with pleural involvement,postoperative ECOG score,differentiation degree,clinical stage,pathological type and GGO status.The area under curve(AUC)of sPD-L1 for postoperative recurrence was 0.730(95%CI:0.671,0.876)and AUC of sPDL1for postoperative survival diagnosis was 0.771(95%CI:0.685,0.907).Cox risk ratio model analysis showed that ECOG score,PD-L1,differentiation degree,clinical stage,GGO status and pleural involvement were the independent prognostic risk factors.Conclusions Overexpression of sPD-L1 is an independent risk factor for postoperative recurrence and prognosis in patients with stage I lung adenocarcinoma after video-assisted thoracoscopic lobectomy combined with lymph node dissection.

关 键 词：可溶性程序性死亡配体-1 I期肺腺癌 预后 

分 类 号：R734.2[医药卫生—肿瘤]