外周血T淋巴细胞亚群及T细胞表面共抑制分子表达水平对PD-1/ PD-L1抑制剂联合化疗治疗NSCLC疗效的预测效能分析  

Predictive efficacy of peripheral blood T lymphocyte subsets and T cell surface co-inhibitory molecule expression levels in the treatment of NSCLC with PD-1/PD-L1 inhibitors combined with chemotherapy

作　　者：杨荣 徐莹 季留连 夏月琴 张林 焦爱民 董正宇 YANG Rong;XU Ying;JI Liulian;XIA Yueqin;ZHANG Lin;JIAO Aimin;DONG Zhengyu(Department of Medical Oncology,the Second People's Hospital of Yancheng,Yancheng,Jiangsu 224000,China)

机构地区：[1]盐城市第二人民医院肿瘤内科,江苏盐城224000

出　　处：《国际检验医学杂志》2023年第16期1974-1978,1983,共6页International Journal of Laboratory Medicine

基　　金：江苏省优势学科建设工程项目(YSHL0816-74)。

摘　　要：目的 探讨外周血T淋巴细胞亚群及T细胞表面共抑制分子表达水平对程序性死亡因子1(PD-1)/程序性死亡因子配体1(PD-L1)抑制剂联合化疗治疗非小细胞肺癌(NSCLC)疗效的预测效能。方法 选取该院2019年5月至2021年4月行PD-1/PD-L1抑制剂联合化疗治疗的NSCLC患者48例,依据治疗4个周期后的效果分为缓解组(n=22)和未缓解组(n=26)。比较两组一般资料及治疗前、治疗4个周期后外周血T淋巴细胞亚群及T细胞表面共抑制分子(CD3^(+)、CD4^(+)、CD8^(+)、PD-1)、肿瘤标志物[糖类抗原125(CA125)、癌胚抗原(CEA)、细胞角蛋白19片段(CYFRA21-1)]水平,分析NSCLC患者外周血T淋巴细胞亚群及T细胞表面共抑制分子与肿瘤标志物的相关性及NSCLC患者疗效影响因素,评价外周血各指标对治疗NSCLC疗效的预测价值。结果 两组治疗4个周期后外周血CD3^(+)、CD4^(+)水平均较本组治疗前提高,且缓解组高于未缓解组,外周血CD8^(+)、PD-1、血清CA125、CEA、CYFRA21-1水平均较本组治疗前降低,且缓解组低于未缓解组,差异有统计学意义(P<0.05)。NSCLC患者治疗4个周期后外周血CD3^(+)、CD4^(+)与血清CA125、CEA、CYFRA21-1水平呈负相关,外周血CD8^(+)、PD-1与血清CA125、CEA、CYFRA21-1水平呈正相关(P<0.05)。建立Logistic预测评估模型,获取联合检测预测未缓解的曲线下面积为0.938,预测灵敏度为80.00%,特异度为90.91%。结论 PD-1/PD-L1抑制剂联合化疗治疗NSCLC后外周血T淋巴细胞亚群及T细胞表面共抑制分子表达水平可出现显著变化,且其表达水平与肿瘤恶性程度有关,对预测疗效具有较高价值。Objective To explore the effects of peripheral blood T lymphocyte subsets and T cell surface co-inhibitory molecule expression levels in the treatment of non-small cell lung cancer(NSCLC)with programmed death factor 1(PD-1)/programmed death factor ligand 1(PD-L1) inhibitor combined with chemotherapy.Methods A total of 48 NSCLC patients who underwent PD-1/PD-L1 inhibitor combined with chemotherapy in a hospital from May 2019 to April 2021 were selected and divided into remission group(n=22) and non-remission group(n=26) according to the efficacy after 4 cycles of treatment.General data,peripheral blood T lymphocyte subsets,T cell surface co-inhibitory molecules(CD3~+,CD4~+,CD8~+,PD-1),tumor markers [carbohydrate antigen 125(CA125),carcinoembryonic antigen(CEA),and cytokeratin 19 fragment(CYFRA21-1)] levels were compared between the two groups before treatment and after 4 cycles of treatment.The correlation between T lymphocyte subsets and T cell surface co-suppressor molecule and tumor markers in peripheral blood of patients with NSCLC were analyzed,as well as the influencing factors of the therapeutic effect of patients with NSCLC,and the predictive value of peripheral blood indicators in the treatment of NSCLC was evaluated.Results After 4 cycles of treatment,peripheral blood CD3~+ and CD4~+ levels of both groups were higher than those before treatment,and the remission group was higher than the non-remission group,while peripheral blood CD8~+,PD-1,serum CA125,CEA and CYFRA21-1 levels were lower than those before treatment,and the remission group was lower than the non-remission group,the differences were statistically significant(P<0.05).Peripheral blood CD3~+ and CD4~+ were negatively correlated with serum CA125,CEA and CYFRA21-1 levels in NSCLC patients after 4 cycles of treatment,while peripheral blood CD8~+ and PD-1 were positively correlated with serum CA125,CEA and CYFRA21-1 levels(P<0.05).A Logistic predictive assessment model was established to obtain an area under the curve of 0.938 for the prediction

关 键 词：T淋巴细胞亚群 T细胞表面共抑制分子 程序性死亡因子1 程序性死亡因子配体1 非小细胞肺癌 

分 类 号：R734.2[医药卫生—肿瘤]