检验医学 ›› 2017, Vol. 32 ›› Issue (2): 99-103.DOI: 10.3969/j.issn.1673-8640.2017.02.007

• 临床应用研究·论著 • 上一篇    下一篇

可溶性程序性死亡分子配体1在肺癌胸腔积液中的水平及临床意义

冀玉珍, 刘晓良, 侯淼   

  1. 商洛市中心医院检验科,陕西 商洛 726000
  • 收稿日期:2016-03-28 出版日期:2017-03-30 发布日期:2017-03-30
  • 作者简介:null

    作者简介:冀玉珍,女,1977年生,学士,主管技师,主要从事临床检验工作。

Level of soluble programmed death-ligand 1 in pleural effusion of lung cancer patients and its clinical significance

JI Yuzhen, LIU Xiaoliang, HOU Miao   

  1. Department of Clinical Laboratory,Shangluo Central Hospital, Shangluo 726000,Shaanxi,China
  • Received:2016-03-28 Online:2017-03-30 Published:2017-03-30

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(sPD-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sPD-L1水平。结果 肺癌组胸腔积液sPD-L1水平为(1.62±0.07)ng/mL,显著高于对照组[(0.90±0.04)ng/mL, P<0.000 1];受试者工作特征(ROC)曲线分析显示,胸腔积液sPD-L1诊断肺癌的最佳切分值为1.33 ng/mL,其敏感性为69.1%, 特异性为94.3%。肺癌患者胸腔积液sPD-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sPD-L1≤1.33 ng/mL者总生存期明显长于胸腔积液sPD-L1>1.33 ng/mL者。Cox比例风险回归分析显示,肺癌患者胸腔积液高sPD-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sPD-L1水平可作为肺癌诊断和预后评判的独立指标。

关键词: 可溶性程序性死亡分子配体1, 诊断, 预后, 肺癌, 胸腔积液

Abstract:

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.

Key words: Soluble programmed death-ligand l, Diagnosis, Prognosis, Lung cancer, Pleural effusion

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