非小细胞肺癌外周血T细胞表面程序性细胞死亡因子1的表达与免疫治疗疗效的相关性研究  

Correlation of PD-1 expression on peripheral blood T cells in non-small cell lung cancer and the efficacy of immunotherapy

作　　者：张慧勤 胡晨曦[1] 惠开元[1] 江艳婷 蒋晓东[1] ZHANG Huiqin;HU Chenxi;HUI Kaiyuan;JIANG Yanting;JIANG Xiaodong(Department of Oncology,Lianyungang First People´s Hospital,Lianyungang,Jiangsu 222003,China)

机构地区：[1]连云港市第一人民医院肿瘤科,江苏连云港222003

出　　处：《安徽医药》2023年第4期706-711,I0001,共7页Anhui Medical and Pharmaceutical Journal

基　　金：江苏省研究生科研与实践创新计划(SJCX21_1152)。

摘　　要：目的探讨非小细胞肺癌(NSCLC)病人外周血CD3^(+)T细胞、CD4^(+)T细胞、CD8^(+)T细胞表面的免疫检查点程序性细胞死亡因子1(PD-1)的表达情况及其与PD-1单抗治疗疗效的相关性分析。方法选取2020年9月至2021年12月在连云港市第一人民医院初步诊断为非小细胞肺癌的病人50例,另外选取该院体检中心的健康体检者40例为本研究的健康对照组。采用流式细胞术(FCM)检测50例NSCLC病人和40例健康对照者的外周血CD3^(+)、CD4^(+)、CD8^(+)T淋巴细胞表面PD-1的表达水平,分析其与临床特征的关系;所有NSCLC病人均接受PD-1单抗治疗,每周期用药前检测PD-1的表达水平,后通过实体瘤免疫疗效评价标准(iRECIST)疗效评价,将病人分为治疗缓解组和治疗耐药组,观察免疫治疗疗效与PD-1的水平变化之间的相关性。结果NSCLC病人外周血CD3+、CD4+、CD8+T淋巴细胞表面PD-1的表达比例均高于健康对照者:(15.57±8.35)比(6.01±2.22)、(16.02±8.66)比(5.70±2.32)、(17.23±9.07)比(6.29±2.65),且CD3+、CD4+、CD8+T淋巴细胞表面PD-1的表达与临床分期、淋巴结转移、远处转移和总生存期有密切的相关性(P<0.05)。免疫治疗缓解组的病人外周血T淋巴细胞表面PD-1的表达比例较用药前的病人明显降低(P<0.05);免疫治疗耐药组PD-1的表达比例较免疫治疗缓解组明显升高(P<0.05)。结论NSCLC病人外周血CD3+、CD4+、CD8+T淋巴细胞表面PD-1的表达与临床分期、远处转移和总生存期显著相关,为NSCLC病人的早期诊断,辅助分期提供帮助及成为PD-1单抗疗效评价的指标,指导用药。Objective To investigate the expression of the immunocheckpoint blockades programmed cell death protein 1(PD-1)on the surface of CD3^(+)T cells,CD4^(+)T cells and CD8^(+)T cells in peripheral blood of patients with non-small cell lung cancer(NSCLC)and its correlation with the therapeutic efficacy of PD-1 monoclonal antibody.Methods Fifty patients who were initially diagnosed with NSCLC from September 2020 to December 2021 at the Lianyungang First People's Hospital were selected,and 40 healthy physical examination participants from the hospital's physical examination center were selected as the healthy control group for this study.Flow cytometry(FCM)was used to detect the expression levels of PD-1 on the surface of CD3^(+),CD4^(+),CD8^(+)T lymphocytes in peripheral blood of 50 NSCLC patients and 40 healthy controls,and the relationship between them and clinical characteristics was analyzed;NSCLC patients were treated with PD-1 monoclonal antibody,and the expression level of PD-1 was detected before each cycle of treatment.After evaluation of the efficacy of immune Response Evaluation Criteria in Solid Tumors(iRECIST),the patients were divided into treatment remission group and treatment resistant group,and the correlation between the efficacy of immunotherapy and the level of PD-1 was observed.Results The expression ratio of PD-1 on the surface of CD3^(+),CD4^(+),CD8^(+)T lymphocytes in peripheral blood of patients with NSCLC was higher than that in healthy controls:(15.57±8.35)vs.(6.01±2.22),(16.02±8.66)vs.(5.70±2.32),(17.23±9.07)vs.(6.29±2.65),and the expression of PD-1 on the surface of CD3^(+),CD4^(+),CD8^(+)T lymphocytes was associated with clinical stage,lymph node metastasis,distant metastasis and overall survival(P<0.05).The expression ratio of PD-1 on the peripheral blood T lymphocytes of the patients in the immunotherapy remission group was significantly lower than that of the patients before treatment(P<0.05);the expression ratio of PD-1 in the immunotherapy resistant group was significantly highe

关 键 词：癌 非小细胞肺 程序性细胞死亡因子1 抗体 单克隆 T细胞 免疫治疗 疗效评估 

分 类 号：R734.2[医药卫生—肿瘤]