SPP1和PD-L1在非小细胞肺癌恶性胸腔积液中的表达及意义  

Expression and significance of SPP1 and PD-L1 in malignant pleural effusion of non-small cell lung cancer

作　　者：吴娟[1] 张鹤 陈虎 杨健 陈亮 魏雨晴 宋勇 WU Juan;ZHANG He;CHEN Hu;YANG Jian;CHEN Liang;WEI Yuqing;SONG Yong(Department of Pathology and Pathophysiology,Wannan Medical College, Wuhu 241000,China)

机构地区：[1]皖南医学院病理生理学教研室,安徽芜湖241000 [2]皖南医学院第一附属医院弋矶山医院呼吸内科,241000 [3]南京大学医学院临床学院东部战区总医院呼吸内科,240002

出　　处：《临床肿瘤学杂志》2021年第10期903-907,共5页Chinese Clinical Oncology

基　　金：国家自然科学基金面上资助项目(81570078);安徽省高校自然科学基金重点项目(KJ2018A0269)。

摘　　要：目的探讨分泌性磷蛋白1(SPP1)和程序性死亡因子配体-1(PD-L1)在呼吸系统良、恶性胸腔积液的表达水平与诊断价值。方法收集26例肺部良性疾病患者胸腔积液标本为对照组,另收集54例非小细胞肺癌合并恶性胸腔积液(MPE)标本为病例组,ELISA法检测各样本SPP1及PD-L1含量。分析两组SPP1、PD-L1表达水平,采用受试者特征工作曲线(ROC)评价SPP1及PD-L1的诊断效能。结果病例组中SPP1、PD-L1表达量分别为(722.59±205.96)ng/ml和(1849.81±771.36)ng/ml,均高于对照组的(576.88±183.02)ng/ml和(1181.08±451.48)ng/ml,差异有统计学意义(P<0.05)。SPP1诊断MPE的截断值为476.84 ng/ml(灵敏度=88.90%,特异度=46.20%,曲线下面积0.708,95%CI:0.588~0.829)。PD-L1诊断MPE的截断值为1745.60 ng/ml(灵敏度=57.40%,特异度=92.30%,曲线下面积0.764,95%CI:0.655~0.872)。通过SPP1与PD-L1串联方法检验二者联合诊断准确率无显著提高。结论SPP1与PD-L1在MPE中均高表达,SPP1与PD-L1表达水平可辅助鉴别呼吸系统良、恶性胸液,二者联合检验效率尚待进一步商榷。Objective To investigate the expression and diagnostic value of secreted phosphoprotein-1(SPP1)and programmed death ligand 1(PD-L1)in benign and malignant pleural effusion of respiratory system.Methods Pleural effusion samples from 26 patients with benign pulmonary diseases were collected as the control group,and 54 patients with non-small cell lung cancer complicated with malignant pleural effusion(MPE)were selected as the case group.The levels of SPP1 and PD-L1 in each sample were detected by ELISA.The expression levels of SPP1 and PD-L1 in the two groups were analyzed,and the diagnostic efficacy of SPP1 and PD-L1 was evaluated by receiver characteristic operating curve(ROC).Results The expression levels of SPP1 and PD-L1 in the case group were(722.59±205.96)ng/ml and(1849.81±771.36)ng/ml,respectively,which were higher than those in the control group(576.88±183.02)ng/ml and(1181.08±451.48)ng/ml.The differences were statistically significant(P<0.05).The value of SPP1 diagnosis MPE was 476.84 ng/ml(sensitivity=88.90%,specificity=46.20%,area under curve 0.708,95%CI:0.588-0.829).PD-L1 diagnosis of MPE truncation value was 1745.60 ng/ml(sensitivity=57.40%,specificity=92.30%,area under curve 0.764,95%CI:0.655-0.872).SPP1 and PD-L1 series test showed no significant improvement in the combined diagnosis accuracy.Conclusion Both SPP1 and PD-L1 are highly expressed in MPE,and the expression levels of SPP1 and PD-L1 can assist in the identification of benign and malignant thoracic fluid in respiratory system.The efficiency of the combined test of the two remains to be further discussed.

关 键 词：非小细胞肺癌 分泌性磷蛋白1 程序性死亡因子配体-1 恶性胸腔积液 诊断价值 

分 类 号：R730.43[医药卫生—肿瘤] R734.2[医药卫生—临床医学]