血浆外泌体PD-L1在ⅢB~Ⅳ期非小细胞肺癌患者中的应用  

Application of Plasma Exosomal PD-L1 in Patients with StageⅢB-ⅣNon-Small Cell Lung Cancer

作　　者：叶梦杰 经慧 武焱旻[2] 陈兰新 高姗姗 刘树安 王慧[2] 陈天恩 Ye Mengjie;Jing Hui;Wu Yanmin;Chen Lanxin;Gao Shanshan;Liu Shu’an;Wang Hui;Chen Tian’en(Postgraduate School,Bengbu Medical University,Bengbu 233030,Anhui,China;Department of Respiratory Medicine,Xuzhou Central Hospital,Xuzhou 221009,Jiangsu,China)

机构地区：[1]蚌埠医科大学研究生院,安徽蚌埠233030 [2]徐州市中心医院呼吸内科,江苏徐州221009

出　　处：《肿瘤预防与治疗》2024年第7期563-570,共8页Journal of Cancer Control And Treatment

基　　金：徐州市2021年推动科技创新项目(编号:KC21167)。

摘　　要：目的:探索血浆外泌体PD-L1在ⅢB~Ⅳ期非小细胞肺癌(non-small cell lung cancer,NSCLC)患者中的应用。方法:选取35例ⅢB~Ⅳ期NSCLC初治患者,收集患者肿瘤组织切片利用免疫组化检测程序性死亡配体1(programmed death ligand 1,PD-L1)表达,收集患者外周静脉血,通过试剂盒检测PD-L1含量,进而分析血浆外泌体PD-L1(exosomal PD-L1,Exo-PD-L1)与肿瘤组织PD-L1表达水平的相关性,以及与临床病理特征的关系。患者行抗PD-1/PD-L1免疫治疗后,每3个月对患者进行irRECIST评估,计算客观缓解率(objective response rate,ORR)及疾病控制率(disease control rate,DCR),探究Exo-PD-L1在预测免疫治疗应答的价值。结果:ⅢB~Ⅳ期NSCLC患者可以表达组织PD-L1及Exo-PD-L1。晚期NSCLC患者中免疫组织化学(immunohistochemistry,IHC)PD-L1阳性和阴性与Exo-PD-L1表达的差异无统计学意义(P=0.072)。卡方检验显示,NSCLC患者Exo-PD-L1的表达与IHC PD-L1表达之间无显著相关性(P=0.086),且晚期NSCLC患者Exo-PD-L1表达与患者临床病理特征(年龄、性别、组织学亚型、吸烟史)之间均无显著相关性(P>0.05)。结论:ⅢB~Ⅳ期NSCLC患者IHC PD-L1与Exo-PD-L1表达无显著相关性,表明ⅢB~Ⅳ期NSCLC患者IHC PD-L1与Exo-PD-L1表达水平不一致。同时Exo-PD-L1表达升高的患者ORR及DCR均高于低表达患者,提示Exo-PD-L1或可用于预测晚期NSCLC患者的预后。Objective:To explore the application of plasma exosomal programmed death ligand-1(PD-L1)in patients with stageⅢB-Ⅳnon-small cell lung cancer(NSCLC).Methods:Thirty-five newly diagnosed patients with stageⅢB-ⅣNSCLC were selected.The expression of PD-L1 in tumor tissue sections was detected by immunohistochemistry(IHC),and the content of PD-L1 in peripheral venous blood was detected by kit.Furthermore,the correlation between exosomal PD-L1(Exo-PD-L1)expression level in plasma and PD-L1 expression level in tumor tissue was analyzed,and the relationship between Exo-PD-L1 expression level in plasma and clinicopathological features was analyzed.After anti-PD-1/PD-L1 immunotherapy,the patients were evaluated by irRECIST every 3 months,and the objective response rate(ORR)and disease control rate(DCR)were calculated to explore the value of Exo-PD-L1 in predicting the response to immunotherapy.Results:Both tissue PD-L1 and Exo-PD-L1 were expressed in stageⅢB-ⅣNSCLC patients.There was no significant difference between positive/negative IHC PD-L1 expression and Exo-PD-L1 expression in advanced NSCLC patients(P=0.072).Chisquare test showed that there was no significant correlation between Exo-PD-L1 expression and IHC PD-L1 expression in NSCLC patients(P=0.086);and there was no significant correlation between Exo-PD-L1 expression and clinicopathological characteristics(age,sex,histological subtype and smoking history)in advanced NSCLC patients(P>0.05).Conclusion:There was no significant correlation between IHC PD-L1 expression and Exo-PD-L1 expression in stageⅢB-ⅣNSCLC patients,indicating that the expression levels of IHC PD-L1 and Exo-PD-L1 in stageⅢB-ⅣNSCLC patients were not consistent.The ORR and DCR of patients with high expression of Exo-PD-L1 were higher than those with low expression,indicating that Exo-PD-L1 can be used to predict the prognosis of patients with advanced NSCLC.

关 键 词：非小细胞肺癌 血浆外泌体PD-L1 免疫治疗 客观缓解率 疾病控制率 

分 类 号：R730.7[医药卫生—肿瘤] R734.2[医药卫生—临床医学]