摘要
目的:探究自然杀伤细胞2组成员A(NKG2A)及程序性死亡因子配体1(PD-L1)表达检测对PD-L1阻断免疫治疗肌层浸润性膀胱癌反应性的预测价值。方法:选取100例肌层浸润性膀胱癌患者作为研究对象,对其行PD-L1阻断免疫治疗后,根据治疗反应性将其分为缓解组和未缓解组;对缓解组患者随访3个月,将其分为复发组和未复发组。比较两组患者NKG2A和PD-L1在CD4^(+)和CD8^(+)上的表达水平,采用ROC曲线分析NKG2A和PD-L1预测膀胱癌患者治疗反应性的价值。结果:100例研究对象中,缓解组患者72例(72.00%),未缓解组患者28例(28.00%),两组性别、年龄比较无统计学差异(均P>0.05),但缓解组患者肿瘤直径小于未缓解组,NKG2A、PD-L1/CD4^(+)和PD-L1/CD8^(+)表达水平均低于未缓解组(均P<0.05)。膀胱癌患者NKG2A、PD-L1/CD4^(+)和PD-L1/CD8^(+)表达预测免疫治疗后缓解的AUC值分别为0.771、0.724、0.710;联合诊断的AUC为0.836。72例缓解患者中,出现复发29例(40.28%),未出现复发43例(59.72%),两组性别、年龄以及肿瘤直径比较无统计学差异(均P>0.05),但复发组NKG2A、PD-L1/CD4^(+)和PD-L1/CD8^(+)表达水平均高于未复发组(均P<0.05)。NKG2A、PD-L1/CD4^(+)和PD-L1/CD8^(+)表达预测膀胱癌患者缓解后复发的AUC值分别为0.775、0.740、0.728;联合诊断的AUC为0.874。结论:NKG2A、PD-L1/CD4^(+)和PD-L1/CD8^(+)在不同治疗反应性肌层浸润性膀胱癌患者外周血中表达水平不同,三者对于膀胱癌患者PD-L1阻断免疫治疗反应性均有一定的预测价值,且三者联合预测效能最佳。
Objective:To explore the value of natural killer cell group 2 member A(NKG2A)and Programmed death factor ligand 1(PD-L1)expression in predicting the responsiveness of PD-L1 blocking immunotherapy for myometrial invasive bladder cancer.Methods:A total of 100 patients with myometrial invasive bladder cancer were selected as the research objects.After PD-L1 blocking immunotherapy,they were divided into remission group and non-remission group according to the response to treatment.The patients in remission group were followed up for 3 months,and they were divided into recurrence group and non-recurrence group.The expression levels of NKG2A and PD-L1 on CD4^(+)and CD8^(+)cells were compared between the two groups.The ROC curve was used to analyze the value of NKG2A and PD-L1 in predicting the treatment response of patients with bladder cancer.Results:Among the 100 patients,72 patients(72.00%)were in the remission group and 28 patients(28.00%)were in the non-remission group.There was no significant difference in gender and age between the two groups(all P>0.05),but the tumor diameter of patients in the remission group was smaller than that in the non-remission group,and the expression levels of NKG2A,PD-L1/CD4^(+)and PD-L1/CD8^(+)were lower than those in the non-remission group(all P<0.05).The AUC values predicted by NKG2A,PD-L1/CD4^(+)and PD-L1/CD8^(+)expression in bladder cancer patients after immunotherapy were 0.771,0.724 and 0.710,respectively,and the AUC of combined diagnosis was 0.836.Of the 72 patients with remission,29(40.28%)had recurrence and 43(59.72%)had no recurrence.There was no significant difference between the two groups in gender,age and tumor diameter(all P>0.05),but the expression levels of NKG2A,PD-L1/CD4^(+)and PD-L1/CD8^(+)in the recurrent group were higher than those in the non-recurrent group(all P<0.05).The AUC values of NKG2A,PD-L1/CD4^(+)and PD-L1/CD8^(+)expression in predicting the recurrence of bladder cancer patients after remission were 0.775,0.740 and 0.728,and the AUC of combined diag
作者
赵刚刚
张鸿毅
肖克兵
杨辉
李子峰
赵华才
ZHAO Ganggang;ZHANG Hongyi;XIAO Kebing;YANG Hui;LI Zifeng;ZHAO Huacai(Department of Urinary Surgery,First Affiliated Hospital of Xi’an Medical University,Xi’an 710077,China)
出处
《陕西医学杂志》
CAS
2024年第2期252-256,共5页
Shaanxi Medical Journal
基金
陕西省自然科学基础研究计划一般项目(青年)(2021JQ-908)。
