外周血sCTLA-4作为晚期非小细胞肺癌患者的预后因子

Peripheral blood sCTLA-4:prognostic factor of patients with advanced non-small cell lung cancer

目的：通过检测晚期非小细胞肺癌（non-small-cell lung cancer，NSCLC）患者外周血可溶性细胞毒性T淋巴细胞相关抗原4（soluble cytotoxic T lymphocyte associated antigen- 4，sCTLA-4）的表达，探讨其与晚期NSCLC患者生存期的关系。方法：采集2010年8月至2013年6月上海中医药大学附属龙华医院肿瘤科经病理证实的58例晚期NSCLC患者和30例正常人的外周血，运用ELISA法检测血中sCTLA-4含量，通过电话随访或上海市疾控中心获得患者生存期数据，分析sCTLA-4表达与NSCLC生存期的关系。结果：NSCLC患者外周血sCTLA-4表达率高于正常人（70.7% vs 6.7%， χ2=32.44，P〈0.01）,外周血sCTLA-4增高的患者中位生存期（MST）较短（41.63个月vs 31.57个月， χ2=7.765，P〈0.01），死亡风险高于其他患者（RR=305， χ2=8.01, P〈0.01）。结论：NSCLC患者外周血中sCTLA-4高表达，sCTLA-4可能成为晚期NSCLC患者的预后因子之一。

Objective：To explore the relationship between soluble cytotoxic T lymphocyte associated antigen-4 （sCTLA-4） and the survival time of advanced NSCLC patients by examine its expressions in peripheral blood of patients. Methods： The research collected the peripheral blood of 58 advanced NSCLC patients confirmed by oncology department of Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from August 2010 to June 2013, and also collected the peripheral blood from 30 healthy persons during the same time period. Researcher used ELISA to test the sCTLA-4 content in the blood, and obtained the data of survival time through telephone follow-up or collected from Shanghai Municipal Center for Disease Control and Prevention, to analyze the relationship between sCTLA-4 and survival time. Results： The sCTLA-4 in peripheral blood of NSCLC patients was higher than that of healthy people （70.7% vs 6.7%, χ2=32.44,P〈001）; the median survival time of the patients with over-expressed sCTLA-4 was shorter （41.63 months vs 31. 57 months, χ2=7.77,P〈0.01） than those patients with low expression, indicating a higher death risk （RR=305, χ2=8.01, P〈0.01）. Conclusion： sCTLA-4 was highly expressed in the peripheral blood of advanced NSCLC patients, and it could be used as one of the prognostic factors for patients with advanced NSCLC.