非小细胞肺癌患者外周血中可溶性程序性死亡配体-1、趋化因子配体9、基质金属蛋白酶9水平与预后生存的关系

Relationship between the levels of soluble programmed death ligand-1,chemokine ligand 9 and matrix metalloproteinase-9 in peripheral blood and the prognosis and survival in patients with non-small cell lung cancer

目的 观察非小细胞肺癌(NSCLC)患者外周血可溶性程序性死亡配体-1(sPD-L1)、趋化因子配体9(CXCL9)、基质金属蛋白酶9(MMP-9)的表达水平与临床特征及预后生存的相关性。方法 我院收治的98例NSCLC患者(研究组),选取同期肺部良性病变患者50例(对照1组)、健康志愿者50例(对照2组),比较三组外周血sPD-L1、CXCL9、MMP-9表达水平。随访研究组治疗后1年的预后生存情况,分为生存组与病死组,采用受试者工作特征(ROC)曲线分析sPD-L1、CXCL9及MMP-9对预后生存的预测价值。结果 研究组外周血sPD-L1、CXCL9、MMP-9水平较对照1组、对照2组高,对照1组较对照2组高(P<0.05);TNM分期为Ⅱ期患者CXCL9、MMP-9表达水平较Ⅰ期高,发生淋巴结转移患者sPD-L1、MMP-9表达水平较未发生淋巴结转移高(P<0.05);NSCLC患者TNM分期与CXCL9、MMP-9水平成正相关,淋巴结转移与sPD-L1、MMP-9水平成正相关(P<0.05);sPD-L1、CXCL9、MMP-9预测NSCLC患者预后的最佳截断值分别为1.915 ng/ml、1.980 ng/ml、179.030μg/L,且三项指标联合预测NSCLC患者预后生存情况的AUC及特异性均高于单一指标预测(P<0.05)。结论 NSCLC患者外周血sPD-L1、CXCL9、MMP-9表达水平上调,且与临床分期、淋巴结转移相关,三者联合对NSCLC患者预后有较高预测价值。

Objective To observe the correlation between the expression levels of soluble programmed death ligand 1(sPDL1),chemokine ligand 9(CXCL9)and matrix metalloproteinase-9(MMP-9)in peripheral blood and the clinical characteristics as well as prognosis and survival in patients with non-small cell lung cancer(NSCLC).Methods Ninety-eight patients with NSCLC in our hospital were selected as a study group.Meanwhile,50 patients with benign pulmonary lesions were selected as a control group-1 and 50 healthy volunteers were selected as a control group-2.The expression levels of sPD-L1,CXCL9 and MMP-9 in peripheral blood of the three groups were compared.The prognosis and survival status in the study group after1 year of treatment were followed up.The patients were further divided into a survival group and a death group.The predictive value of sPD-L1,CXCL9 and MMP-9 for prognosis and survival was analyzed using ROC curve analysis.Results The expression levels of sPD-LI,CXCL9 and MMP-9 in peripheral blood of the study group were higher than those in the control group-1 and control group-2,and the expression levels in the control group-1 were higher than those in the control group-2(P<0.05).The expression levels of CXCL9 and MMP-9 in patients with TNM stage II were higher than those in patients with stage I.The expression levels of sPD-LI and MMP-9 in patients with lymph node metastasis were higher than those in patients without metastasis(P<0.05).TNM staging was positively correlated with CXCL9 and MMP-9 levels and lymph node metastasis was positively correlated with sPD-L1 and MMP-9 levels in patients with NSCLC(P<0.05).The optimal cut-off values of sPD-L1,CXCL9 and MMP-9 for predicting the prognosis of NSCLC were 1.915 ng/ml,1.980 ng/ml and 179.030μg/L,respectively.Moreover,the AUC and specificity of the three indicators jointly predicting the prognosis and survival of NSCLC patients were higher than those predicted by a single indicator(P<0.05).Conclusions The expression levels of sPD-L1,CXCL9 and MMP-9 in peripheral blood of patients with NSCLC are up-regulated and closely related to clinical staging and lymph node metastasis.The combined detection of the three is of high value in predicting the prognosis of patients with NSCLC.