摘要
目的检测肺癌患者胸腔积液可溶性程序性死亡分子配体1(s PD-L1)的水平,并评估其对伴有胸腔积液肺癌的诊断及预后判断的价值。方法收集肺癌合并胸腔积液患者(肺癌组)68例,以性别、年龄、吸烟状态与肺癌组相匹配的良性肺部病变伴胸腔积液患者70例作为对照组,采用酶联免疫吸附试验(ELISA)检测胸腔积液s PD-L1水平。结果肺癌组胸腔积液s PD-L1水平为(1.62±0.07)ng/m L,显著高于对照组[(0.90±0.04)ng/m L,P<0.000 1];受试者工作特征(ROC)曲线分析显示,胸腔积液s PD-L1诊断肺癌的最佳切分值为1.33 ng/m L,其敏感性为69.1%,特异性为94.3%。肺癌患者胸腔积液s PD-L1水平与患者年龄、性别、吸烟状况、病理类型均无关(P>0.05),而在肺癌不同分化程度、肿瘤大小、TNM分期及有无淋巴结转移患者间差异有统计学意义(P<0.05)。Kaplan-Meier生存曲线分析显示,肺癌患者胸腔积液s PD-L1≤1.33 ng/m L者总生存期明显长于胸腔积液s PD-L1>1.33 ng/m L者。Cox比例风险回归分析显示,肺癌患者胸腔积液高s PD-L1水平是肺癌患者不良预后的独立指标[危险比(HR)=2.402,95%可信区间(CI)1.323~4.360,P<0.05]。结论胸腔积液s PD-L1水平可作为肺癌诊断和预后评判的独立指标。
Objective To investigate the level of soluble programmed death-ligand l(sPD-L1),and to evaluate its diagnostic and prognostic significance in lung cancer patients with pleural effusion. Methods A total of 68 lung cancer patients with pleural effusion were enrolled. A total of 70 benign lung disease patients with pleural effusion matching in sex,age and smoking were enrolled as controls. The level of sPD-L1 in pleural effusion was determined by enzyme-linked immunosorbent assay(ELISA). Results The level of sPD-L1 in lung cancer patients [(1.62±0.07) ng/mL] was higher than that in controls [(0.90±0.04)ng/mL,P<0.000 1]. Receiver operating characteristic(ROC)curve showed that sPD-L1 level of 1.33 ng/mL was optimal for diagnosing lung cancer patients with pleural effusion. The sensitivity and specificity were 69.1% and 94.3%. The level of sPD-L1 did not correlate with age,sex,smoking and pathological type(P>0.05),but there was statistical significance for differentiation,tumor size,TNM stage and lymph node metastasis(P<0.05). Kaplan-Meier survival curves showed that patients with sPD-L1 level ≤1.33 ng/mL had a favorable overall survival than those with sPD-L1 level >1.33 ng/mL. By Cox proportional hazard regression analysis,high sPD-L1 level was an independent predictive marker for poor prognosis in lung cancer patients [hazard ratio(HR)=2.402,95% confidence interval(CI)1.323-4.360,P<0.05]. Conclusions The level of sPD-L1 is of significance for the diagnosis and prognosis for lung cancer patients with pleural effusion.
作者
冀玉珍
刘晓良
侯淼
JI Yuzhen;LIU Xiaoliang;HOU Miao(Department of Clinical Laboratory,Shangluo Central Hospital, Shangluo 726000,Shaanxi,China)
出处
《检验医学》
CAS
2017年第2期99-103,共5页
Laboratory Medicine
