血清FGL1、LncSChLAP1对晚期非小细胞肺癌免疫治疗效果及预后评估的价值  

The value of serum FGL1 and LncSChLAP1 in the assessment of immune therapeutic effect and prognosis of advanced non-small cell lung cancer

作　　者：夏宁[1] 周泽军 方申存[1] 王尊乔[2] 潘宴青[2] Xia Ning;Zhou Zejun;Fang Shencun;Wang Zunqiao;Pan Yanqing(Department of Respiratory Medicine,Nanjing Chest Hospital,Jiangsu Province,Nanjing 210029,China;不详)

机构地区：[1]江苏省南京市胸科医院呼吸内科,210029 [2]江苏省南京市胸科医院胸外科,210029

出　　处：《疑难病杂志》2024年第3期346-351,共6页Chinese Journal of Difficult and Complicated Cases

基　　金：江苏省第十六批“六大人才高峰”高层次人才项目(YY-118);南京市医学科技发展资金一般性课题(YKK17185)。

摘　　要：目的分析血清纤维蛋白样因子1(FGL1)、长链非编码RNA SChLAP1(LncSChLAP1)评估接受免疫治疗的晚期非小细胞肺癌(NSCLC)患者疗效及预后的价值。方法选取2019年4月—2022年12月南京市胸科医院呼吸内科诊治晚期NSCLC患者98例为NSCLC组,均接受免疫检查点抑制剂治疗,根据疗效分为有效亚组74例和无效亚组24例,以同期医院健康体检者50例为健康对照组。酶联免疫吸附实验检测NSCLC患者血清FGL1水平,实时荧光定量PCR检测血清LncSChLAP1水平;多因素Logistic回归分析影响晚期NSCLC患者化疗疗效的因素;受试者工作特征曲线分析血清FGL1、LncSChLAP1对晚期NSCLC患者免疫治疗疗效的预测价值;Kaplan-Meier曲线分析血清FGL1、LncSChLAP1对晚期NSCLC患者生存预后的影响。结果血清FGL1、LncSChLAP1水平比较,NSCLC组高于健康对照组(t/P=57.365/<0.001、28.443/<0.001)。无效亚组TNM分期Ⅳ期比例、血清FGL1、LncSChLAP1水平高于有效亚组(χ^(2)/P=15.375/<0.001,t/P=35.077/<0.001、35.127/<0.001)。血清FGL1、LncSChLAP1高是影响晚期NSCLC患者免疫治疗疗效的独立危险因素[OR(95%CI)=1.327(1.104~1.596)、1.415(1.094~1.829)];血清FGL1、LncSChLAP1及两项联合的AUC分别为0.856、0.792、0.905,两者联合优于各自单独预测效能(Z/P=4.258/0.007、5.119/<0.001)。FGL1高、低表达组1年总体生存率分别为22.92%(11/48)、60.00%(30/50),LncSChLAP1高、低表达组1年总体生存率分别为27.66%(13/47)、54.90%(28/51),FGL1高表达组、LncSChLAP1高表达组晚期NSCLC患者1年累积生存率分别低于FGL1低表达组、LncSChLAP1低表达组(χ^(2)/P=14.180/<0.001、17.553/<0.001)。结论晚期NSCLC患者血清FGL1、LncSChLAP1升高,是新的评估晚期NSCLC患者免疫治疗疗效及生存预后的血清标志物。Objective To investigate the efficacy and prognostic evaluation value of fibrin like factor 1(FGL1)and long chain non-coding RNA SChLAP1(LncSChLAP1)in immunotherapy for patients with advanced non-small cell lung cancer(NSCLC).Method Ninety-eight patients with advanced NSCLC diagnosed and treated in the Department of Respiratory Medicine of Nanjing Chest Hospital from April 2019 to December 2022 were selected as the NSCLC group,all of them were treated with immune checkpoint inhibitors,and were divided into effective subgroups(74 cases)and ineffective subgroups(24 cases)according to the therapeutic efficacy,and 50 cases of those who had a healthy physical examination in hospitals during the same period of time were selected as the healthy control group.The NDT was detected by enzyme-linked immunosorbent assay.Enzyme-linked immunosorbent assay(ELISA)was used to detect serum FGL1 levels in NSCLC patients,and real-time fluorescence quantitative PCR was used to detect serum LncSChLAP1 levels;multifactorial logistic regression analysis was used to analyze the factors affecting the efficacy of chemotherapy in patients with advanced NSCLC;subjects'work characteristic curves were used to analyze the predictive value of serum FGL1 and LncSChLAP1 on the efficacy of immunotherapy in patients with advanced NSCLC The predictive value of serum FGL1 and LncSChLAP1 on the survival and prognosis of advanced NSCLC patients was analyzed by Kaplan-Meier curve.Results The serum FGL1 and LncSChLAP1 levels were higher in the NSCLC group than in the healthy control group(t/P=57.365/<0.001,28.443/<0.001).The proportion of TNM stage IV,serum FGL1,and LncSChLAP1 levels were higher in the ineffective subgroup than in the effective subgroup(χ^(2)/P=15.375/<0.001,t/P=35.077/<0.001,35.127/<0.001).Serum FGL1 andLncSChLAP1 were independent risk factors affecting the efficacy of immunotherapy in patients with advanced NSCLC[OR(95%CI)=1.327(1.104-1.596),1.415(1.094-1.829)];serum FGL1,LncSChLAP1 and the AUC of the two combined were 0.856,0.792,and

关 键 词：非小细胞肺癌 纤维蛋白样因子1 长链非编码RNA SChLAP1 免疫治疗 疗效 预后 

分 类 号：R734.2[医药卫生—肿瘤]