肺腺癌患者外周血sLAG-3、sPD-L1水平与胸腔镜根治术后复发的相关性

Correlation between levels of sLAG-3 and sPD-L1 in peripheral blood and recurrence of lung adenocarcinoma after thoracoscopic radical resection

目的:分析肺腺癌患者外周血可溶性淋巴细胞活化基因-3(sLAG-3)、可溶性程序性死亡受体-1(sPD-L1)水平与胸腔镜根治术后复发的相关性。方法:抽取2017年1月至2018年12月于郑州市第九人民医院行胸腔镜根治术的肺腺癌患者90例,回顾性统计术后随访2年肺腺癌复发及未复发情况。应用Logistic回归分析胸腔镜根治术后肺腺癌复发的影响因子,绘制受试者工作特征曲线并记录曲线下面积(AUC)。结果:90例患者术后随访时间为3~24(12.03±3.15)个月,其中复发26例(28.89%),未复发64例(71.11%)。复发者外周血sLAG-3、sPD-L1水平低于未复发者(t=13.752、10.285,P=0.001、0.001)。Logistic回归分析结果显示,外周血sLAG-3、sPD-L1水平低表达可能是肺腺癌患者胸腔镜根治术后复发的影响因子(OR=8.236、6.395,P=0.041、0.002)。外周血sLAG-3、sPD-L1单项及二者联合预测肺腺癌术后复发,AUC=0.892、0.896、0.969。结论:接受胸腔镜根治术治疗的肺腺癌患者,如果术前外周血sLAG-3、sPD-L1水平呈低表达,可能提示术后有较高的复发风险。

Objective To analyze the correlation between the levels of soluble lymphocyte activating gene-3(sLAG-3)and soluble programmed death receptor-1(sPD-L1)in peripheral blood and the recurrence of lung adenocarcinoma after thoracoscopic radical resection.Methods A total of 90 patients with lung adenocarcinoma who underwent thoracoscopic radical resection at the Ninth People’s Hospital of Zhengzhou from January 2017 to December 2018 were collected and retrospectively counted the recurrence and non-recurrence of lung adenocarcinoma during the 2-year follow-up.Logistic regression was used to analyze the influencing factors of lung adenocarcinoma recurrence after thoracoscopic radical resection,and the receiver operating characteristic curve was drawn and the area under the curve(AUC)was recorded.Results The postoperative follow-up time of 90 patients was 3-24(12.03±3.15)months,among them,26 cases(28.89%)recurred and 64 cases(71.11%)did not recur.The peripheral blood sLAG-3 and sPD-L1 levels of relapsed patients were lower than those of non-relapsed patients(t=13.752,10.285,P=0.001,0.001).Logistic regression analysis showed that the low expression of sLAG-3 and sPD-L1 in peripheral blood may be an influencing factor for the recurrence of patients with lung adenocarcinoma after thoracoscopic radical resection(OR=8.236,6.395,P=0.041,0.002).Peripheral blood sLAG-3,sPD-L1 single item and the combination of the two predicted the recurrence of lung adenocarcinoma after operation,AUC=0.892,0.896,0.969.Conclusions If the preoperative levels of sLAG-3 and sPD-L1 in peripheral blood of patients with lung adenocarcinoma who receives thoracoscopic radical resection for treatment are low,it may indicate that there is a high risk of recurrence after thoracoscopic radical resection.