非小细胞肺癌中PD1/PD-L1信号通路与EGFR突变的相关性研究

Research on correlation between PD1/PD-L1 signaling pathway and EGFR mutation in non-small cell lung cancer

目的观察非小细胞肺癌(NSCLC)中细胞程序性死亡分子1/细胞程序性死亡分子1配体(PD1/PD-L1)信号通路与表皮生长因子受体(EGFR)突变的相关性。方法选取2017年6月至2020年6月该院收治的NSCLC患者113例作为研究对象,记录患者一般资料,检测PD1/PD-L1表达,评估EGFR突变情况,分析PD1/PD-L1信号通路与EGFR突变的关系,并检验PD1/PD-L1信号通路对EGFR突变的预测效能。结果113例患者中发生EGFR突变41例,发生率为36.28%;EGFR突变组TNM分期与未发生EGFR突变组比较,差异有统计学意义(P<0.05);EGFR突变组女性、合并胸内播散、PD1/PD-L1阳性占比均高于未发生EGFR突变组,差异有统计学意义(P<0.05);两组患者年龄、性别、吸烟史、饮酒史、高血压史、糖尿病史、高血脂史、肿瘤分型、病程、肿瘤最大径、远处转移情况比较,差异均无统计学意义(P>0.05);性别(女性)、TNM分期(Ⅳ期)、合并胸内播散、PD1/PD-L1阳性均与NSCLC患者EGFR突变发生有关(P<0.05);患者性别、TNM分期、胸内播散、PD1/PD-L1均与EGFR突变的发生相关(r=0.227、0.279、0.311、0.525,P<0.05);PD1/PD-L1用于预测EGFR突变的受试者工作特征曲线下面积大于或等于0.70,具有一定的预测价值。结论NSCLC患者EGFR突变风险较高,与PD1/PD-L1阳性密切相关,可将PD1/PD-L1作为EGFR突变的预测因子。

Objective To investigate the correlation between the signaling pathway of programmed cell death molecule-1/programmed cell death molecule-1 ligand(PD1/PD-L1)and epidermal growth factor receptor(EGFR)mutation in non-small cell lung cancer(NSCLC).Methods A total of 113 patients with NSCLC admitted to this hospital from June 2017 to June 2020 were selected as the research subjects,their general data were recorded,the expression of PD1/PD-L1 protein was detected,the EGFR mutation was evaluated,the relationship between PD1/PD-L1 signaling pathway and EGFR mutation was analyzed,and the predictive efficiency of PD1/PD-L1 signaling pathway for EGFR mutation was tested.Results In 113 cases of NSCLC,41 cases had the EGFR mutation,the incidence rate was 36.28%;the TNM stage had statistical difference between the EGFR mutation group and non-EGFR mutation group(P<0.05);the female,complicating intrathoracic dissemination and proportion of PD1/PD-L1 in the EGFR mutation group were higher than those in the non-EGFR mutation group,and the differences were statistically significant(P<0.05).The age,gender,histories of smoking,drinking,hypertension,diabetes mellius and hyperlipidemia,tumor type,disease course,tumor maximal diameter and distant metastasis had no statistically significant differences between the twogroups(P>0.05);the gender(female),TNM stage(stage IV),complicating intrathoracic dissemination and PD1/PD-L1 positive all were associated with the EGFR mutation occurrence in the patients with NSCLC(P<0.05);the gender,TNM stage,intrathoracic dissemination and PD1/PD-L1 were correlated to the EGFR mutation(r=0.227,0.279,0.311,0.525,P<0.05);the area under the receiver operating curve(ROC)curve(AUC)of PD1/PD-L1 for predicting EGFR mutation was≥0.70,which had certain predictive value.Conclusion The patients with NSCLC have a high risk of EGFR mutation,which is closely correlated to the PD1/PD-L1 positive.PD1/PD-L1 could serve as a predictive fctor of EGFR mutation.