程序性死亡配体-1 表达对I 期肺腺癌术后 患者预后的价值

Predictive value of programmed death ligand - 1 on postoperative stage I lung adenocarcinoma

摘要:

目的 探究程序性死亡配体-1（PD-L1）表达对Ⅰ期肺腺癌肺叶切除联合系统性淋巴结清扫术后患 者预后的价值。方法 收集86 例经电视胸腔镜下肺叶切除联合系统性淋巴结清扫术的I 期浸润性肺腺癌的患者， 检测其血清中可溶性程序性死亡配体-1（sPD-L1），分析sPD-L1 对术后复发及生存的预测价值。结果 sPD-L1 高表达胸膜受累、术后ECOG 评分、分化程度、临床分期、病理类型及GGO 状态具有相关性（P <0.05）。 sPD-L1 对术后复发诊断的曲线下面积AUC 为0.730（95%CI ：0.671，0.876），对术后生存诊断的AUC 为0.771 （95%CI ：0.685，0.907）。Cox 风险比例模型分析显示，ECOG 评分、PD-L1、分化程度、临床分期、GGO 状态 及胸膜受累为术后预后的影响因素。结论 sPD-L1 高表达为I 期肺腺癌患者经电视胸腔镜肺叶切除联合系统 淋巴结清扫术后复发、预后生存的危险因素。

Abstract:

Objective To investigate the prognostic value of programmed death ligand 1 (PD-L1) in patients with stage I lung adenocarcinoma post lobectomy combined with systemic lymphadenectomy. Methods A total of 86 patients with stage I infiltrating lung adenocarcinoma undergoing thoracoscopic lobectomy combined with systemic lymphadenectomy were enrolled in this study. Serum PD-L1 (sPD-L1) was measured. Association of PD-L1and clinical characteristics was identified. Results Concentration of sPD-L1 was significantly correlated with pleural involvement, postoperative ECOG score, differentiation degree, clinical stage, pathological type and GGO status. The area under curve (AUC) of sPD-L1 for postoperative recurrence was 0.730 (95% CI: 0.671, 0.876) and AUC of sPDL1for postoperative survival diagnosis was 0.771 (95% CI: 0.685, 0.907). Cox risk ratio model analysis showed that ECOG score, PD-L1, differentiation degree, clinical stage, GGO status and pleural involvement were the independent prognostic risk factors. Conclusions Overexpression of sPD-L1 is an independent risk factor for postoperative recurrence and prognosis in patients with stage I lung adenocarcinoma after video-assisted thoracoscopic lobectomy combined with lymph node dissection.