血清中PD-L1水平与非小细胞癌患者免疫功能的相关性

Correlation Between PD-L1 in Serum and Immune Function in Patients with Non-small Cell Lung Cancer

目的 探究血清中程序性细胞死亡受体-配体-1(PD-L1)水平与非小细胞癌(NSCLC)患者免疫功能的相关性。方法 回顾性选取NSCLC患者共94例,另外选取48例健康体检人员作为对照组。根据细胞免疫功能对纳入研究的NSCLC患者进行分组,统计一般资料、病变部位、病理组织类型、体力状况分级(ECOG PS)、肺癌T分期、PD-L1表达等信息,采用单因素回归分析评估上述项目与免疫功能的关系;另外,分别统计PD-L1阳性、阴性患者的流式细胞检测结果,比较2组CD3+、CD3+CD4+、CD3+CD8+、CD4+/CD8+、CD56+以及CD19+水平。结果 单因素分析结果显示,患者年龄高于60周岁、腺癌、T3+T4且PD-L1水平呈阳性者,免疫重度损伤病例数占比存在统计学差异(P<0.05);PD-L1阳性、阴性2组的CD3+、CD3+CD4+、CD56+水平差异有统计学意义(P<0.05),然而CD3+CD8+、CD4+/CD8+以及CD19+水平差异无统计学意义(P>0.05)。结论 NSCLC患者血清中的PD-L1存在显著异常表达,高水平PD-L1提示患者存在细胞免疫功能抑制,对于患者免疫功能的评估具有参考意义。

Objective To explore the correlation between programmed cell death receptor ligand-1(PD-L1)in serum and immune function in patients with non-small cell lung cancer(NSCLC).Methods A total of 94 patients with NSCLC were retrospectively enrolled,while 48 healthy controls were enrolled as the control group.NSCLC patients were grouped according to cellular immune function.The general data,lesion sites,types of pathological tissues,grading of performance status(ECOG PS),T staging of lung cancer and PD-L1 expression were statistically analyzed,and the relationship between the above-mentioned indexes and immune function was evaluated by univariate regression analysis.The results of flow cytometry in patients with PD-L1 positive and negative were statistically analyzed.The levels of CD3+,CD3+CD4+,CD3+CD8+,CD4+/CD8+,CD56+and CD19+were compared between the 2 groups.Results Univariate analysis showed that differences in proportions of cases with severe immune damage among patients with age>60 years,adenocarcinoma,T staging at stage T3+T4 and PD-L1 positive were statistically significant(P<0.05)There were significant differences in levels of CD3+,CD3+CD4+and CD56+between PD-L1 positive group and negative group(P<0.05),but there was no significant difference in levels of CD3+CD8+,CD4+/CD8+or CD19+(P>0.05).Conclusion There is significant abnormal expression of PD-L1 in serum of patients with NSCLC.High level of PD-L1 indicates suppressed cellular immune function,which has reference significance for the evaluation of immune function.