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