L选择素在不同分期NSCLC患者中的表达水平及其与放射治疗疗效的关系  

The distribution of CD62L on peripheral blood T cell surface of patients with varying stages of non-small cell lung cancer and its correlation with the radiotherapy outcome

作　　者：刘亚男 王静怡[1] Liu Yanan;Wang Jingyi(Department of Radiotherapy,Shanri Province Cancer Hospital,Shanri Hospital Affiliated to Cancer Hospital,Chinese Academy of Medical Sciences,Cancer Hospital Affiliated to Shanri Medical University,Taiyuan 030000,China)

机构地区：[1]山西省肿瘤医院、中国医学科学院肿瘤医院山西医院、山西医科大学附属肿瘤医院放射治疗科,太原030000

出　　处：《国际呼吸杂志》2024年第7期816-824,共9页International Journal of Respiration

摘　　要：目的探究L选择素(CD62L)在不同分期非小细胞肺癌(NSCLC)患者外周血T细胞表面的表达水平及其与放射治疗疗效的关系。方法本研究为横断面研究。采用目的抽样法选取2020年11月至2023年10月于山西省肿瘤医院收治的NSCLC患者270例, 其中Ⅰ期40例, Ⅱ期48例, Ⅲ期102例, Ⅳ期80例。比较不同分期患者的临床资料和放射治疗疗效。采用多因素logistic回归分析模型分析CD62L水平与NSCLC患者Ⅲ期/Ⅳ期风险的相关性。根据放射治疗疗效将患者分为治疗有效组(181例)和治疗无效组(89例), 比较2组患者临床资料。构建广义线性混合模型判断CD62L水平与NSCLC患者放射治疗无效之间的关系。应用样条函数与logistic回归相结合的限制性立方样条法分析CD62L水平与NSCLC患者放射治疗无效的剂量反应关系。结果共纳入270例NSCLC患者, 其中男129例, 女141例, 年龄(57.48±4.53)岁, 年龄范围40~68岁。不同分期NSCLC患者在白细胞介素6(IL-6)、血小板计数(PLT)、C反应蛋白(CRP)、肿瘤长径、降钙素原、D-二聚体、中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)、CD62L水平方面的差异均有统计学意义(均P<0.05)。多因素logistic回归分析结果显示, 校正年龄、性别、身体质量指数、IL-6、PLT、CRP、肿瘤长径、降钙素原、D-二聚体、NLR、PLR协变量后, CD62L水平与患者Ⅲ期/Ⅳ期风险仍存在独立相关性(OR=1.899, 95%CI:1.015~2.358)。不同分期NSCLC患者放射治疗疗效差异有统计学意义(χ^(2)=21.68, P<0.05), Ⅲ期、Ⅳ期患者治疗无效占比较高, 分别为26.47%(27/102)、48.75%(39/80)。治疗有效组中完全缓解88例(32.59%)、部分缓解93例(34.44%);治疗无效组中疾病稳定53例(19.63%)、疾病进展36例(13.33%)。治疗无效组患者年龄、IL-6、PLT、肿瘤长径、NLR、PLR、CD62L水平均高于治疗有效组患者, Ⅲ/Ⅳ期患者比例高于治疗有效组患者(均P<0.05)。广�Objective:To explore the expression level of L-selectin(CD62L)on peripheral blood T cell surface of patients with varying stages of non-small cell lung cancer(NSCLC)and its correlation with the radiotherapy outcome.Methods:This was a cross-sectional study involving 270 NSCLC patients admitted to Shanxi Cancer Hospital from November 2020 to October 2023 by objective sampling method,including 40 stageⅠpatients,48 stageⅡpatients,102 stageⅢpatients,and 80 stageⅣpatients.The clinical data and radiotherapy outcome of NSCLC patients with different clinical stages were compared.Multivariate logistic regression analysis model was used to analyze the correlation between CD62L level and the risk of stageⅢ-ⅣNSCLC.According to the radiotherapy outcome,NSCLC patients were assigned into effective group(181 cases)and ineffective group(89 cases).The clinical data of the two groups were compared.The generalized linear mixed model was constructed to determine the correlation between CD62L level and radiotherapy failure in NSCLC patients.The limited cubic spline method combined with logistic regression was used to analyze the dose-response relationship between CD62L level and radiotherapy failure in NSCLC patients.Results:A total of 270 NSCLC patients were included,including 129 males and 141 females with a mean age of 57.48±4.53(40-68)years.There were significant differences in interleukin-6(IL-6),platelet count(PLT),C-reactive protein(CRP),tumor diameter,procalcitonin,D-dimer,neutrophil to lymphocyte ratio(NLR),platelet-lymphocyte ratio(PLR)and CD62L levels in NSCLC patients with varying stages(all P<0.05).Multivariate logistic regression analysis showed that after adjustment for covariates of age,gender,body mass index,IL-6,PLT,CRP,tumor diameter,procalcitonin,D-dimer,NLR,and PLR,CD62L level was still independently correlated with the risk of stageⅢ-ⅣNSCLC(OR=1.899,95%CI:1.015-2.358).There was significant difference in the therapeutic effect of radiotherapy on NSCLC at varying clinical stages(χ^(2)=21.68,P<0.05)

关 键 词：癌 非小细胞肺 L选择素 分期 外周血 疗效 

分 类 号：R734.2[医药卫生—肿瘤]