非小细胞肺癌患者抗PD-1/PD-L1治疗疗效及其肠道菌群特征分析  

Analysis of anti-PD-1/PD-L1 therapeutic effect and intestinal flora characteristics in patients with non-small cell lung cancer

作　　者：李帅 韩雪[1] 马文静 徐蓉[3] 王昌敏[1] LI Shuai;HAN Xue;MA Wenjing;XU Rong;WANG Changmin(Department of Clinical Laboratory,People′s Hospital of Xinjiang Uygur Autonomous Region,Urumqi,Xinjiang 830001,China;Department of Clinical Laboratory,Urumqi Traditional Chinese Medicine Hospital,Urumqi,Xinjiang 830002,China;Department of Oncology,People′s Hospital of Xinjiang Uygur Autonomous Region,Urumqi,Xinjiang 830001,China)

机构地区：[1]新疆维吾尔自治区人民医院检验科,新疆乌鲁木齐830001 [2]乌鲁木齐市中医医院检验科,新疆乌鲁木齐830002 [3]新疆维吾尔自治区人民医院肿瘤科,新疆乌鲁木齐830001

出　　处：《国际检验医学杂志》2024年第4期505-508,512,共5页International Journal of Laboratory Medicine

基　　金：新疆维吾尔自治区自然科学基金项目(2019D01C221)。

摘　　要：目的分析非小细胞肺癌(NSCLC)患者抗程序性死亡受体1(PD-1)/程序性死亡配体1(PD-L1)治疗疗效及其肠道菌群特征。方法将2020年1月至2022年1月新疆维吾尔自治区人民医院收治的81例NSCLC患者作为研究对象,根据患者免疫治疗应答情况,将患者分为无应答组及应答组,比较两组患者临床资料及肠道菌群分布差异,并采用Spearman相关性分析患者无进展生存期(PFS)与肠道菌群α多样性指标之间的相关性。结果应答组吸烟患者比例显著低于无应答组,差异有统计学意义(χ^(2)=4.648,P=0.031)。无应答组Chao1指数、ACE指数及香农-威纳指数患者低于应答组,辛普森多样性指数高于应答组,差异有统计学意义(P<0.05)。Chao1指数、ACE指数及香农-威纳指数与PFS呈正相关(r=0.526、0.579、0.539,均P<0.05),而辛普森多样性指数与PFS呈负相关(r=-0.867,P<0.001)。采用主坐标分析对肠道菌群β多样性结构进行分析,第一主成分贡献率为70.36%,第二主成分贡献率为16.63%。结论NSCLC患者肠道菌群多样性及分布与抗PD-1/PD-L1治疗有关,患者肠道菌群多样性越高,抗PD-1/PD-L1治疗越敏感。Objective To analyze the therapeutic effect of anti-programmed death receptor 1(PD-1)/programmed death ligand 1(PD-L1)and the characteristics of intestinal flora in patients with non-small cell lung cancer(NSCLC).Methods A total of 81 NSCLC patients admitted to the People′s Hospital of Xinjiang Uygur Autonomous Region from January 2020 to January 2022 were taken as the research object.According to the patients′immunotherapy response,the patients were divided into non-response group and response group.The differences in clinical data and intestinal flora distribution between the two groups were compared,and the correlation between PFS and intestinal floraαdiversity index was analyzed by Spearman correlation.Results The proportion of smoking patients in response group was significantly lower than that in non-response group,and the difference was statistically significant(χ^(2)=4.648,P=0.031).Chao1 index,ACE index and shannon wiener index patients in non-response group were lower than those in response group,while Simpson diversity index was higher than that in response group,with statistical significance(P<0.05).Chao1 index,ACE index and shannon wiener index were positively correlated with PFS(r=0.526,0.579 and 0.539,all P<0.05),while Simpson diversity index was negatively correlated with PFS(r=-0.867,P<0.001).The principal coordinate analysis was used to analyze theβdiversity structure of intestinal flora.The first principal component contribution rate was 70.36%,and the second principal component contribution rate was 16.63%.Conclusion The diversity and distribution of intestinal flora in NSCLC patients are related to anti-PD-1/PD-L1 therapy.The higher the diversity of intestinal flora,the more sensitive the anti-PD-1/PD-L1 therapy.

关 键 词：非小细胞肺癌 程序性死亡受体1/程序性死亡配体1 肠道菌群 

分 类 号：R734.2[医药卫生—肿瘤]