肝细胞癌患者免疫检查点抑制剂治疗期间可溶性CD27变化与生存时间的关系  

Dynamic Changes of Plasma sCD27 Levels and Survival of Hepa-tocellular Carcinoma Patients Receiving Immune Checkpoint In-hibitor Therapy

作　　者：演何钦 白素琴[1] 段发强 YAN Heqin;BAI Suqin;DUAN Faqiang(3201 Hospital Affiliated to Xi'an Jiaotong University School of Medicine,Hanzhong 723000,China)

机构地区：[1]西安交通大学医学院附属三二〇一医院,陕西汉中723000

出　　处：《肿瘤学杂志》2024年第9期761-768,共8页Journal of Chinese Oncology

基　　金：陕西省科学技术重点研发(2019SF-16)。

摘　　要：[目的]评估可溶性CD27(soluble CD27,s CD27)在免疫检查点抑制剂(immune checkpoint inhibitors,ICIs)治疗期间的变化与肝细胞癌患者生存时间的关系。[方法]回顾性分析2017年10月至2022年3月接受ICIs方案治疗的72例肝细胞癌患者资料,在免疫治疗开始(基线)和免疫治疗第6周时通过多重荧光珠的免疫测定法检测s CD27、可溶性程序性细胞死亡蛋白1(s PD-1)和可溶性程序性死亡配体1(s PD-L1)。Δ变化值指ICIs治疗第6周时各指标与基线值的变化百分比。随访追踪患者的总生存期(overall survival,OS)、进展时间(time to progression,TTP)、无进展生存期(progression-free survival,PFS)。单因素及多因素Cox回归分析Δ-s CD27与OS、TTP、PFS的相关性。[结果]Δ-s CD27≥2.63%的肝细胞癌患者BCLC分期更多为C/D期。Δ-s CD27与肝细胞癌患者的OS、PFS及TTP相关。Kaplan-Meier绘图分析结果显示,Δ-s CD27≥2.63%的肝细胞癌患者OS(Log-rankχ^(2)=14.499,P<0.001)、PFS(Log-rankχ^(2)=7.274,P=0.007)以及TTP(Log-rankχ^(2)=8.605,P=0.003)更短。[结论]Δ-s CD27≥2.63%提示晚期肝细胞癌患者ICIs治疗后生存预后较差,临床可通过监测血浆s CD27水平指导临床决策。[Objective]To analyze the relationship between change of plasma soluble CD27(sCD27)level and the survival of patient with hepatocellular carcinoma(HCC)receiving immune checkpoint inhibitor(ICIs)therapy.[Methods]Clinical data of 72 HCC patients treated with ICIs from October 2017 to March 2022 were retrospectively analyzed.Plasma levels of sCD27,soluble programmed cell death pro-tein 1(sPD-1),and soluble programmed cell death ligand 1(sPD-L1)were detected by multi-bead im-munoassays before(baseline)and 6 weeks after immunotherapy.Patients were followed,and the overall survival(OS),time to progression(TTP)and progression-free survival(PFS)were documented.The cor-relation between the changes of sCD27 level(Δ-sCD27)and the OS,TTP and PFS of patients were ana-lyzed by univariate and multivariate Cox regression analysis,and the prognostic value ofΔ-sCD27 in HCC was analyzed by Kaplan-Meier curve.[Results]Univariate and multivariate Cox regression analysis showed thatΔ-sCD27 was associated with PFS and TTP in HCC patients,andΔ-sCD27 was an inde-pendent predictor of OS.More HCC patients withΔ-sCD27≥2.63%had BCLC stage C/D.Kaplan-Meier curve analysis showed that HCC patients withΔ-sCD27≥2.63%had significant shorter OS(Log-rankχ^(2)=14.499,P<0.001),PFS(Log-rankχ^(2)=7.274,P=0.007)and TTP(Log-rankχ^(2)=8.605,P=0.003).[Conclusion]Δ-sCD27≥2.63%may indicate a poor survival prognosis of advanced HCC patients after ICIs treatment,and can evaluate the efficacy of ICIs treatment by monitoring plasma sCD27 level.

关 键 词：肝细胞癌患者 CD27 免疫检查点抑制剂 免疫测定法 Cox回归分析 临床决策 免疫治疗 基线值 

分 类 号：R735.7[医药卫生—肿瘤]