PDCD1和PD-L1及CTLA-4基因联合检测非小细胞肺癌预后评估  

Value of combined detection of PDCD1,PD-L1 and CTLA-4 gene expression in the prognosis of non-small cell lung cancer patients

作　　者：张国桥[1] 彭浩[2] 曾蓉[1] ZHANG Guo-qiao;PENG Hao;ZENG Rong(First Peoples Hospital of Yunnan Province Kunming 650032,China)

机构地区：[1]云南省第一人民医院肿瘤内科,云南昆明650032 [2]云南省第一人民医院胸外科,云南昆明650032

出　　处：《中华肿瘤防治杂志》2021年第4期280-285,共6页Chinese Journal of Cancer Prevention and Treatment

基　　金：云南省卫生科技计划项目(2014NSR66)。

摘　　要：目的探讨细胞程序性死亡蛋白1(PDCD1)、程序性死亡因子配体-1(PD-L1)和细胞毒性T淋巴细胞抗原4(CTLA-4)联合检测对非小细胞肺癌(NSCLC)的临床应用价值。方法收集2012-01-01-2014-05-31在云南省第一人民医院肿瘤内科接受手术治疗的NSCLC患者70例。采用聚合酶链反应(RT-qPCR)检测PDCD1、PD-L1和CTLA-4在NSCLC癌组织和癌旁组织中的表达,并随访生存情况。采用受试者工作特征曲线(ROC)分析PDCD1、PD-L1和CTLA-4对NSCLC患者生存状况的预测价值。采用Kaplan-Meier和Log-rank检验进行单因素分析,采用多因素Cox回归模型分析影响NSCLC患者预后的独立危险因素。结果 NSCLC癌组织中的PDCD1(56.07±13.64,t=20.505,P<0.001)、PD-L1(33.34±10.39,t=8.584,P<0.001)和CTLA-4(35.38±11.03,t=6.820,P<0.001)表达水平均高于癌旁组织(19.49±6.06;21.00±6.06;24.86±6.70),差异有统计学意义。ROC曲线分析显示PDCD1、PD-L1和CTLA-4对NSCLC患者预后均有一定预测价值,且3者联合检测对NSCLC预后预测效能更佳。多因素Cox回归分析显示,吸烟(HR=1.60,95%CI:1.35~1.90)、PDCD1(HR=1.80,95%CI:1.47~2.21)、PD-L1(HR=2.44,95%CI:1.64~3.63)和CTLA-4(HR=1.96,95%CI:1.45~2.65)高表达、TNMⅡ~Ⅲ期(HR=2.20,95%CI:1.65~2.93)、淋巴结转移(HR=1.96,95%CI:1.35~2.84)可能是NSCLC患者预后的独立危险因素。结论 PDCD1、PD-L1和CTLA-4 3者联合检测可能对NSCLC患者的预后具有一定预测价值。癌组织中PDCD1、PD-L1和CTLA-4高表达可能是NSCLC患者预后的独立危险因素。Objective To investigate the clinical value of combined detection of PDCD1,PD-L1 and CTLA-4 in patients with non-small cell lung cancer(NSCLC).Methods Seventy patients with NSCLC who underwent surgical treatment in the Department of Oncology,First People’s Hospital of Yunnan Province from 1 January 2012 to 31 May 2014 were recruited.The expression of PDCD1,PD-L1 and CTLA-4 in NSCLC cancer and adjacent tissues were meausured by RT-qPCR,and the survival status was followed up.Receiver operating characteristic curve(ROC)was used to analyze the predictive value of PDCD1,PD-L1 and CTLA-4 on the survival status of NSCLC patients.Kaplan-Meier with Log-rank test were used for univariate analysis.Multivariate Cox regression model was used to analyze the independent risk factors affecting the prognosis of NSCLC patients.Results The expression levels of PDCD1(56.07±13.64 vs 19.49±6.06,t=20.505,P<0.001),PD-L1(33.34±10.39 vs 21.00±6.06,t=8.584,P<0.001)and CTLA-4(35.38±11.03 vs.24.86±6.70,t=6.820,P<0.001)in NSCLC cancer tissues were significantly higher than those in adjacent tissues(19.49±6.06;21.00±6.06;24.86±6.70).ROC curve analysis showed that PDCD1,PD-L1 and CTLA-4 had certain predictive value for the prognosis of NSCLC patients,and the combined measurements of PDCD1,PD-L1 and CTLA-4 had better predictive value for the prognosis of NSCLC patients.Multivariate Cox regression analysis showed that smoking(HR=1.60,95%CI:1.35-1.90),PDCD1(HR=1.80,95%CI:1.47-2.21),PD-L1(HR=2.44,95%CI:1.64-3.63),CTLA-4(HR=1.96,95%CI:1.45-2.65),TNM stageⅡ-Ⅲ(HR=2.20,95%CI:1.65-2.93),and lymph node metastasis(HR=1.96,95%CI:1.35-2.84)were independent prognostic risk factors for NSCLC.Conclusions The combined measurements of PDCD1,PD-L1 and CTLA-4 may have predictive value for the prognosis of NSCLC patients.The overexpression of PDCD1,PD-L1 and CTLA-4 in cancer tissues may be an independent risk factor for the prognosis of NSCLC patients.

关 键 词：非小细胞肺癌 细胞程序性死亡蛋白1 程序性死亡因子配体-1 细胞毒性T淋巴细胞抗原4 

分 类 号：R734.2[医药卫生—肿瘤]