SCC-Ag、PD-L1、RRM1表达对中晚期肺鳞癌患者化疗效用的评估价值及与患者预后的关系分析

An Evaluation of the Expression of SCC-Ag,PD-L1 and RRM1 on the Efficacy of Chemotherapy in Patients with Intermediate and Advanced Lung Squamous Cell Carcinoma and Analysis of Its Relationship with Prognosis

目的分析鳞细胞癌抗原(SCC-Ag)、程序性死亡分子配体1(PD-L1)、核苷酸还原酶M1(RRM1)表达对中晚期肺鳞癌患者化疗效用的诊断价值及与患者预后的相关性。方法回顾性分析2020年1月至2021年6月入我院接受化疗的肺鳞癌患者共122例。观察患者化疗后临床疗效,并根据患者病情建立PR组、SD组、PD组,对比各组患者化疗前后SCC-Ag、PD-L1、RRM1水平变化情况,采用ROC曲线分析SCC-Ag、PD-L1、RRM1单一指标及联合检测模式对患者化疗效果的评估价值。对比各组患者生活质量评分,采用Pearson相关系数分析SCC-Ag、PD-L1、RRM1与患者生活质量(KPS)评分的相关性。结果所有患者化疗结束后均接受临床评估且未见完全缓解患者,PR患者共37例(占比30.32%)纳入PR组,SD患者51例(占比41.80%)纳入SD组,PD患者共34例(占比27.87%)纳入PD组;化疗后PR组、SD组各指标水平较化疗前相比均明显降低,PD组各指标水平较化疗前相比均明显升高(均P<0.05),化疗后各组间各指标对比均P<0.05;采用ROC曲线分析显示单一指标检测的ROC曲线下面积均较低,3者联合检测的ROC曲线下面积最高(AUC=0.912);化疗结束后,各组KPS评分随着化疗疗效的升高而升高(P<0.05);采用Pearson相关系数分析显示SCC-Ag、PD-L1、RRM1与患者KPS评分结果呈负相关(P<0.05)。结论中晚期肺鳞癌患者SCC-Ag、PD-L1、RRM1表达与患者化疗后疗效具有相关性,上述3项指标会影响到患者预后及生活质量,后续临床可通过SCC-Ag、PD-L1、RRM13项指标检测并密切关注患者的病情发展情况,针对性地调整并完善诊疗方案,有助于改善患者预后。

Objective To analyze the diagnostic value of the expression of squamous cell carcinoma antigen(SCC-Ag),programmed death molecule ligand 1(PD-L1)and nucleotide reductase M1(RRM1)in patients with intermediate and advanced lung squamous cell carcinoma and its correlation with prognosis.Methods A total of 122 patients with lung squamous cell carcinoma who received chemotherapy in our hospital from January,2020 to June,2021 were retrospectively analyzed.Clinical efficacy of patients after chemotherapy was observed,and PR group,SD group and PD group were established according to patients’conditions.Changes in SCC-Ag,PD-L1 and RRM1 levels in each group were compared before and after chemotherapy.ROC curve was used to analyze the evaluation value of single indicators of SCC-Ag,PD-L1 and RRM1 and the combined detection mode for the chemotherapy effect of patients.The quality of life score of patients in each group was compared,and the correlation between SCC-Ag,PD-L1,RRM1 and patients’quality of life(KPS)score was analyzed by Pearson correlation coefficient.Results All patients received clinical evaluation after chemotherapy and no complete remission was found.37 patients with PR(30.32%)were included in PR group,51 patients with SD(41.80%)were included in SD group,and 34 patients with PD(27.87%)were included in PD group.After chemotherapy,levels of each index in PR group and SD group were significantly lower than those before chemotherapy,and levels of each index in PD group were significantly higher than those before chemotherapy(all P<0.05).After chemotherapy,levels of indexes in PR group and SD group were significantly lower than before chemotherapy,and levels of indexes in PD group increased significantly than before chemotherapy(all P<0.05).The differences of indexes among groups after chemotherapy were all significant with P<0.05.ROC curve analysis showed that the area under the curve detected by single index was lower,and the area under the curve detected by the combination of the three indexes was the highest(AUC=0.912).After chemotherapy,KPS score of each group increased with the increase of chemotherapy efficacy(P<0.05).Pearson correlation coefficient analysis showed that SCC-Ag,PD-L1,RRM1 were negatively correlated with KPS score(P<0.05).Conclusion Expressions of SCC-Ag,PD-L1 and RRM1 in patients with intermediate and advanced lung squamous cell carcinoma are correlated with the efficacy after chemotherapy,and the above three indicators can affect the prognosis and quality of life of patients.In follow-up clinical tests,SCC-Ag,PD-L1 and RRM1 indicators can be used to detect and monitor the disease development of patients,so clinicians can adjust and improve the diagnosis and treatment plan accordingly to improve the prognosis.