PD-1和PD-L1表达预测非小细胞肺癌患者发生免疫检查点抑制剂相关性肺炎价值分析  

Value of PD-1 and PD-L1 expression in predicting immune checkpoint inhibitor-associated pneumonia in non-small cell lung cancer patients

作　　者：赖茜茜[1] 林快鹿[2] LAI Xixi;LIN Kuailu(Department of Respiratory and Critical Care Medicine,the First Affiliated Hospital of Wenzhou Medical University,Wenzhou 325000,China;不详)

机构地区：[1]温州医科大学附属第一医院呼吸与危重症医学科,325000 [2]温州医科大学附属第一医院乳腺外科,325000

出　　处：《浙江医学》2024年第24期2657-2660,共4页Zhejiang Medical Journal

基　　金：温州市科技局基础性公益科研项目(Y2023378)。

摘　　要：目的探讨程序性死亡受体1(PD-1)和程序性死亡受体-配体1(PD-L1)表达预测非小细胞肺癌(NSCLC)患者发生免疫检查点抑制剂相关性肺炎(CIP)的价值。方法回顾性选择2022年1月至2023年6月温州医科大学附属第一医院收治的100例接受免疫治疗的NSCLC患者,依据患者是否发生CIP分为CIP组31例与无CIP组69例。采用ELISA法测定患者血清PD-1和PD-L1表达水平。比较两组患者血清PD-1和PD-L1表达水平的差异;绘制ROC曲线,评估PD-1和PD-L1预测NSCLC患者发生CIP的效能;采用多因素logisitc回归分析NSCLC患者发生CIP的独立危险因素。结果CIP组血清PD-1和PD-L1表达水平均显著高于无CIP组(均P<0.05)。ROC曲线显示,PD-1预测NSCLC患者发生CIP的灵敏度为0.774,特异度为0.710;PD-L1预测NSCLC患者发生CIP的灵敏度为0.681,特异度为0.884。多因素logisitc回归分析显示,年龄、吸烟史、基础肺功能、肺部放疗史、PD-1和PD-L1表达是影响NSCLC患者发生CIP的独立危险因素(均P<0.05)。结论NSCLC患者发生CIP时血清PD-1和PD-L1呈高表达,使用PD-1和PD-L1预测NSCLC患者发生CIP灵敏度和特异度良好;PD-1和PD-L1表达是影响NSCLC患者发生CIP的独立危险因素。Objective To explore the value of programmed death receptor 1(PD-1)and programmed death receptor ligand 1(PD-L1)expression in predicting immune checkpoint inhibitor-associated pneumonia(CIP)in non-small cell lung cancer(NSCLC)patients.Methods Clinical data of 100 NSCLC patients who received immunotherapy at the First Affiliated Hospital of Wenzhou Medical University from January 2022 to June 2023 were retrospectively analyzed,among whom CIP developed in 31 cases(CIP group)and did not develop in 69 cases(non-CIP group).The expression levels of PD-1 and PD-L1 in the serum of patients were measured using ELISA method and compared between two groups.The independent risk factors for CIP in NSCLC patients were identified by multiple logistic regression analysis,and the value of PD-1 and PDL1 expression in predicting CIP was analyzed with ROC curve.Results The expression levels of serum PD-1 and PDL1 in CIP group were significantly higher than those in non-CIP group(both P<0.05).ROC curve analysis showed that the sensitivity and specificity of PD-1 in predicting CIP in NSCLC patients were 0.774 and 0.710,respectively;those of PD-L1 were 0.681 and 0.884,respectively.Multivariate logistic regression analysis showed that age,smoking history,baseline lung function,history of lung radiation therapy,PD-1 and PD-L1 expression were independent risk factors for developing CIP in NSCLC patients(all P<0.05).Conclusion Higher expression levels of serum PD-1 and PD-L1 are independent risk factors for the occurrence of CIP in NSCLC patients,which may be used to predict CIP in NSCLC patients clinically.

关 键 词：程序性死亡受体1 程序性死亡受体-配体1 非小细胞肺癌 免疫检查点抑制剂相关性肺炎 

分 类 号：R563.1[医药卫生—呼吸系统] R734.2[医药卫生—内科学]