不同阈值程序性死亡配体-1的表达在非表皮生长因子受体突变的肺腺癌患者中的临床意义

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中文摘要：目的评估不同阈值程序性死亡配体-1(PD-L1)的表达对非表皮生长因子受体(EGFR)突变的肺腺癌患者的治疗效果及其预后的影响.方法回顾性分析75例接受PD-L1免疫治疗的非EGFR突变的肺腺癌患者的临床资料,应用免疫组化检测患者中不同阈值下PD-L1的表达水平.分析比较不同阈值PD-L1表达水平与患者临床资料的相关性以及对患者预后的影响.结果 75例患者中,PD-L1＜1％和PD-L1 ≥1％组中,PD-L1的表达水平与患者性别、年龄、ECOG评分、TNM分期、Ki-67和淋巴结转移等因素无关(P＞0.05);PD-L1＜5％和PD-L1≥5％组中,PD-L1的表达与Ki-67及淋巴结转移有关(P＜0.05).PD-L1＜1％和PD-L1≥1％组中,PD-L1的表达与化疗客观有效率、PFS及OS均无统计学差异(ORR58.5％vs 38.2％,P=0.106;mPFS 18.4 个月 vs 21.2 个月,P=0.158;mOS 28.1 个月 vs 32.7 个月,P=0.156).PD-L1＜5％和PD-L1≥5％组中,PD-L1的表达与化疗客观有效率、PFS有统计学差异(ORR 36.8％vs 61.1％,P=0.013;mPFS 17.1个月vs 23.2个月,P=0.020).以TPS 5％为界,单因素分析Ki-67 ≥15％、淋巴结转移及PD-L1表达阳性是影响非EGFR突变肺腺癌患者PFS的危险因素(P=0.031,P=0.003,P=0.004);多因素分析中PD-L1表达阳性是影响无病生存期的独立危险因素(P=0.001).结论不同阈值PD-L1的表达在非EGFR突变的肺腺癌患者中存在较大差异,提示不同阈值界定的PD-L1的表达可作为该类患者个体化治疗的预测指标.

外文标题：Clinical Study of Programmed Death Ligand-1 Expression With Different Thresholds In Non-epidermal Factor Growth Receptor-mutated Lung Adenocarcinoma Patients

外文摘要：Objective To evaluate the therapeutic effect of programmed death ligand-1(PD-L1)expression with differ-ent thresholds in non-epidermal factor growth receptor(EGFR)mutated lung adenocarcinoma patients and its impact on progno-sis.Methods The clinical data of 75 patients with non-EGFR mutated lung adenocarcinoma who received PD-L1 immunotherapy were retrospectively analyzed.The expression levels of PD-L1 under different thresholds in patients were detected by immunohisto-chemistry.The correlation of different threshold PD-L1 expression levels with clinical data and prognosis of patients were analyzed and compared.Results In 75 NSCLC patients,PD-L1 expression level was not related to gender,age,ECOG score,TNM stage,Ki-67 and lymph node metastasis in PD-L1＜1％group and PD-L1 ≥1％group(P＞0.05).In PD-L1＜5％and PD-L1 ≥5％groups,the expression of PD-L1 was correlated with Ki-67 and lymph node metastasis(P＜0.05).There was no significant differ-ence between the PD-L1 expression and the objective response rate,PFS and OS of chemotherapy in the PD-L1＜1％group and PD-L1 ≥1％group.(ORR 58.5％vs 38.2％,P=0.106;mPFS:18.4 vs21.2 months,P=0.158;mOS28.1 months vs 32.7 months,P=0.156).In the PD-L1＜5％group and PD-L1 ≥5％group,PD-L1 expression was significantly associated with objec-tive response rate and PFS.(ORR 36.8％vs61.1％,P=0.013;mPFS:17.1 vs23.2 months,P=0.020).Using TPS5％as the boundary,Ki-67≥ 15％,lymph node metastasis and positive PD-L1 expression were the risk factors for PFS in non-EGFR-mutated lung adenocarcinoma patients(P=0.031,P=0.003,P=0.004).Multivariate analysis showed that PD-L1 expression was an in-dependent risk factor for disease-free survival(P=0.001).Conclusion There are significant differences in PD-L1 expression with different thresholds in non-EGFR mutated lung adenocarcinoma patients,suggesting that PD-L1 expression with different thresholds can be used as a predictor for individualized treatment of these patients.

外文关键词：

Non-small cell lung cancerAdenocarcinomaProgrammed death ligand-1Epidermal growth factor receptorTherapeutic effectPrognosis

作者：

宋开放、李桂芳、孙江涛

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作者单位：

471000 河南科技大学第一附属医院临床医学院

关键词：

非小细胞肺癌腺癌程序性死亡配体-1 表皮生长因子受体治疗效果预后

基金：

河南省重点研发与推广专项支持项目洛阳市科技发展重点项目河南省医学科技攻关计划联合共建项目

项目编号：

2221023103392202005ALHGJ20200571

出版年：

2024

DOI：

10.3969/j.issn.1001-5930.2024.07.010

实用癌症杂志

江西省肿瘤医院　江西省肿瘤研究所

实用癌症杂志

影响因子：1.241

ISSN：1001-5930

年,卷(期)：2024.39(7)