血清HIF-1α、PD-L1、VEGF-C、VEGFR-3水平对非小细胞肺癌患者淋巴结转移的预测价值  

Predictive Value of Serum HIF-1α,PD-L1,VEGF-C and VEGFR-3 Levels in Lymph Node Metastasis in Patients with Non-small Cell Lung Cancer

作　　者：李敏[1] 王媛[1] 李震[1] 郑芝欣[1] LI Min;WANG Yuan;LI Zhen(Nanyang Central Hospital,Nanyang,473000)

机构地区：[1]河南省南阳市中心医院,473000

出　　处：《实用癌症杂志》2025年第2期218-222,226,共6页The Practical Journal of Cancer

摘　　要：目的 探究非小细胞肺癌(NSCLC)患者血清缺氧诱导因子-1α(HIF-1α)、程序性细胞死亡蛋白1(PD-L1)、血管内皮生长因子C(VEGF-C)、血管内皮生长因子受体3(VEGFR-3)水平及其对淋巴结转移的预测价值。方法 收集109例NSCLC患者临床资料。依照患者淋巴结转移情况分为转移组(18例)和非转移组(91例)。比较两组基础资料、HIF-1α、PD-L1、VEGF-C、VEGFR-3水平;分析HIF-1α、PD-L1、VEGF-C、VEGFR-3与NSCLC临床特征的关系;进一步明确HIF-1α、PD-L1、VEGF-C、VEGFR-3对淋巴结转移的预测价值。结果 两组年龄、性别、病理类型、肿瘤部位、肿瘤分叶比较,差异无统计学意义,P>0.05;两组肿瘤直径、TMN分期差异显著,P<0.05。转移组HIF-1α、PD-L1、VEGF-C、VEGFR-3水平均高于非转移组,差异显著(P<0.05)。HIF-1α、PD-L1、VEGF-C、VEGFR-3水平与年龄、性别、病理类型、肿瘤部位、肿瘤分叶无关,与肿瘤直径、TMN分期可能有关,肿瘤直径≥2 cm、TMN分期为Ⅲ+Ⅳ期患者的HIF-1α、PD-L1、VEGF-C、VEGFR-3水平均高于肿瘤直径<2 cm、TMN分期为Ⅰ+Ⅱ期患者,差异显著(P<0.05)。HIF-1α、PD-L1、VEGF-C、VEGFR-3的预测阈值分别为:68.960 ng/L、361.070 pg/ml、507.730 ng/L、1202.645 ng/L。HIF-1α、PD-L1、VEGF-C、VEGFR-3联合预测NSCLC淋巴结转移的AUC最高,为0.843,灵敏度、特异度均高于单一指标。结论 HIF-1α、PD-L1、VEGF-C、VEGFR-3水平均在NSCLC淋巴结转移下异常增加,四者联合对NSCLC淋巴结转移有良好的预测价值,可作为临床上的NSCLC淋巴结转移评估因子。Objective To investigate the serum levels of hypoxia-inducible factor-1α(HIF-1α),programmed cell death protein 1(PD-L1),vascular endothelial growth factor C(VEGF-C)and vascular endothelial growth factor receptor 3(VEGFR-3)in patients with non-small cell lung cancer(NSCLC)and their predictive value for lymph node metastasis.Methods The clinical data of 109 patients with NSCLC were collected.Patients with lymph node metastasis were divided into metastatic group(18 cases)and non-metastatic group(91 cases).Basic data,levels of HIF-1α,PD-L1,VEGF-C and VEGFR-3 were compared between the 2 groups.The relationship between HIF-1α,PD-L1,VEGF-C,VEGFR-3 and clinical features of NSCLC was analyzed.The predictive value of HIF-1α,PD-L1,VEGF-C and VEGFR-3 in lymph node metastasis was further determined.Results There were no significant differences in age,sex,pathological type,tumor site and tumor segmentation between the 2 groups(P>0.05),while there were significant differences in tumor diameter and TMN staging between the 2 groups(P<0.05).The levels of HIF-1α,PD-L1,VEGF-C and VEGFR-3 in metastasis group were significantly higher than those in non-metastasis group(P<0.05).HIF-1α,PD-L1,VEGF-C and VEGFR-3 levels were not related to age,sex,pathological type,tumor site and tumor segmentation,but may be related to tumor diameter and TMN staging.The levels of HIF-1α,PD-L1,VEGF-C and VEGFR-3 in patients with tumor diameter≥2 cm and TMN stageⅢ+Ⅳwere higher than those in patients with tumor diameter<2 cm and TMN stageⅠ+Ⅱ,and the differences were significant(P<0.05).The predicted thresholds of HIF-1α,PD-L1,VEGF-C and VEGFR-3 were 68.960 ng/L,361.070 pg/ml,507.730 ng/L and 1202.645 ng/L,respectively.The AUC of HIF-1α,PD-L1,VEGF-C and VEGFR-3 combined to predict NSCLC lymph node metastasis was the highest(0.843),and the sensitivity and specificity were higher than that of a single index.Conclusion HIF-1α,PD-L1,VEGF-C and VEGFR-3 levels all increase abnormally in NSCLC lymph node metastasis,and the combination of the fou

关 键 词：非小细胞肺癌 HIF-1Α PD-L1 VEGF-C VEGFR-3 淋巴结转移 预测 

分 类 号：R734.2[医药卫生—肿瘤]