基于肿瘤微环境建立NSCLC免疫治疗疗效预测模型及其初步探索  

Establishment of prediction model of NSCLC immunotherapy efficacy based on tumor microenvironment and its preliminary exploration

作　　者：曾政 杨鹤玲 刘宇[1] 王勇[1] 徐强[1] 蒋鸥[1] ZENG Zheng;YANG Heling;LIU Yu;WANG Yong;XU Qiang;JIANG Ou(The Fourth Oncology Department,the Second People's Hospital of Neijiang,Neijiang,Sichuan,641000,China)

机构地区：[1]内江市第二人民医院肿瘤四科,四川内江641000

出　　处：《肿瘤药学》2022年第2期208-214,共7页Anti-Tumor Pharmacy

基　　金：国家科技重大专项-重大新药创制项目(2018ZX09303-014)。

摘　　要：目的利用免疫组化技术筛选非小细胞肺癌(NSCLC)肿瘤微环境中具有重要意义的免疫指标,建立NSCLC免疫治疗疗效预测模型。方法回顾性分析2013年至2015年我院收治并经手术病理确诊的NSCLC患者46例,采用聚类分析进行分组,收集病理标本及相关临床数据,采用聚类分析法及t检验对免疫组化指标进行降维筛选,建立NSCLC免疫治疗疗效预测模型,依据免疫细胞浸润密度及位置进行命名。通过接受免疫检查点抑制剂治疗的11例NSCLC患者进行验证,评估该模型的预测效能。结果通过聚类分析将46例患者分为两组,分别为8例、38例,两组患者中位无病生存期(mDFS)分别为14.33个月、25.84个月(P=0.015),中位总生存期(mOS)分别为16.00个月、28.70个月(P=0.021)。利用聚类分析及t检验将16个免疫指标降维至7个,根据Fisher判别函数建立免疫治疗疗效预测模型,进一步分析两组免疫细胞情况,分别命名为免疫低反应型和免疫高反应型,评估结果显示该模型具有较好的预测价值。结论基于肿瘤微环境建立的NSCLC免疫治疗疗效预测模型为NSCLC免疫治疗的疗效评估提供了一种新的方法。Objective To establish an efficacy prediction model for immunotherapy of non-small cell lung cancer(NSCLC)by screening the important immune indexes in the tumor microenvironment on the base of immunohistochemical technique.Methods A retrospective analysis was made on 46 patients with NSCLC conformed by postoperative pathology in our hospital between 2013 and 2015.Patients were divided into groups by cluster analysis,and their pathological sam‑ples and related clinical data were collected.The immunohistochemical indexes were screened by cluster analysis and t test for dimensionality reduction.A prediction model of NSCLC immunotherapy efficacy was established,and named ac‑cording to the density and location of immune cell infiltration.The predictive effectiveness of the model was evaluated by validation in 11 cases of NSCLC patients who had immune checkpoint inhibitors treatment.Results The 46 patients were divided into two groups by cluster analysis,8 patients in group 1 and 38 in group 2.The median disease-free survival(mDFS)of patients was 14.33 months in group 1 and 25.84 months in group 2(P=0.015).The median overall survival(mOS)of patients were respectively 16.00 months and 28.70 months in the two groups(P=0.021).The dimension was re‑duced from 16 immune indexes to 7 by cluster analysis and t test.Using these indexes,the prediction model of immunother‑apy efficacy was established according to the Fisher discriminant function.The immune cells in the two groups were further analyzed and separately named as immune low response type and immune high response type.The evaluation results showed that the model had a good prediction value.Conclusion The prediction model of NSCLC immunotherapy efficacy based on tumor microenvironment provides a new method for evaluating the efficacy of NSCLC immunotherapy.

关 键 词：非小细胞肺癌 肿瘤微环境 免疫组化 免疫治疗 预测模型 

分 类 号：R734.2[医药卫生—肿瘤]