血清RASSF1A甲基化评估PD-1单抗治疗非小细胞肺癌疗效的临床价值  

Clinical Value of Serum RASSF1A Methylation in Evaluating Efficacy of Anti-PD-1 Therapy for Non-small-cell Lung Cancer

作　　者：赵球 何光照[1] 肖敏[2] ZHAO Qiu;HE Guang-zhao;XIAO Min(Changzhou Tumor Hospital Affiliated to Soochow University,Changzhou,213000,China)

机构地区：[1]苏州大学附属常州市肿瘤医院,江苏常州213000 [2]苏州大学附属常州市肿瘤医院肿瘤内科,江苏省常州市213000

出　　处：《肿瘤学杂志》2021年第5期369-373,共5页Journal of Chinese Oncology

基　　金：常州市卫生计生委重大科技项目(ZD201611)。

摘　　要：[目的]评价RASSF1A基因甲基化水平变化评估程序性细胞死亡蛋白1(programmed cell death,,PD-1)单抗治疗晚期转移性非小细胞肺癌(non-small cell lung cancer,NSCLC)疗效以及预后中的价值。[方法]研究纳入70例Ⅳ期NSCLC患者,在PD-1单抗治疗前(基线)、每次影像学评估疗效的时间点收集血清标本检测RASSF1A基因甲基化,RASSF1A基因甲基化水平和临床反应之间的关系分析使用非参数Wilcoxon符号秩检验。所有患者均通过影像学评估及电话随访获得无进展生存时间(progression-free survival,PFS),采用Kaplan-Meier和Logrank检验绘制生存曲线。[结果]在治疗有效亚组中,血清RASSF1A基因甲基化水平与基线相比明显下降(P<0.01),相反,在治疗无效亚组中,血清RASSF1A基因甲基化水平与基线相比明显上升(P<0.01)。血清RASSF1A基因甲基化水平降低与NSCLC患者具有较好的PFS相关(P=0.0072)。[结论]血清RASSF1A基因甲基化水平可以用来预测PD-1单抗治疗的晚期NSCLC的临床疗效。[Objective]To analyze the value of serum RASSF1A methylation status in evaluating the efficacy of anti-PD-1 therapy for non-small-cell lung cancer(NSCLC)and the prognosis of patients.[Methods]Seventy patients with stageⅣNSCLC were treated with anti-PD-1 m Abs.The efficacy of treatment was evaluated by imaging findings,the progression-free survival(PFS)of patients was analyzed with Kaplan-Meier curve.Serum RASSF1A methylation levels were detcected,the association between RASSF1A methylation levels and clinical response was analyzed using the nonparametric Wilcoxon matched-pairs ranked tests.The progression-free survival time were obtained by imaging evaluation and telephone follow-up of all the patients.Kaplan-Meier and the Log-rank test were used to plot the survival curve.[Results]In responding patients,serum RASSF1A methylation levels significantly decreased compared with baseline levels(P<0.01),while in non-responders,serum RASSF1A methylation levels significantly increased(P<0.01).The decreased RASSF1A methylation levels were associated with longer PFD in metastatic NSCLC patients(P=0.0072).[Conclusion]The detection of serum RASSF1A methylation level may be used to monitor and predict clinical efficacy of anti-PD-1 in NSCLC patients.

关 键 词：非小细胞肺癌 RASSF1A 甲基化 程序性细胞死亡蛋白1 

分 类 号：R734.2[医药卫生—肿瘤]