广西医学2023，Vol.45Issue(19)：2310-2314,2342,6.DOI:10.11675/j.issn.0253-4304.2023.19.03
原发性非小细胞肺癌患者PD-1/PD-L1抑制剂治疗后发生肿瘤治疗相关心功能不全的危险因素
Risk factors for the occurrence of cancer treatment-related cardiac dysfunction in patients with primary non-small cell lung cancer after PD-1/PD-L1 inhibitors therapy
摘要
Abstract
Objective To investigate the risk factors for patients with primary non-small cell lung cancer(NSCLC)suffering from cancer treatment-related cardiac dysfunction(CTRCD)after programmed death 1(PD-1)/programmed death ligand 1(PD-L1)inhibitors therapy.Methods The clinical data of 192 patients with primary NSCLC receiving PD-1/PD-L1 inhibitors therapy were retrospectively analyzed,and they were assigned to CTRCD group(n =18)or non-CTRCD group(n = 174)according to the presence of CTRCD occurred.The clinical data were compared between the CTRCD group and the non-CTRCD group.The risk factors for patients with primary NSCLC suffering from CTRCD after receiving PD-1/PD-L1 inhibitors therapy were analyzed by using the multivariate Logistic regression model.The efficiency of risk factors for alone and jointly predicting patients suffering from CTRCD was evaluated by employing the receiver operating characteristic(ROC)curve.Results Patients of the CTRCD group obtained a higher proportion of concomitant hypertension,and higher hemoglobin level,red blood cell distribution width-standard deviation(RDW-SD),plasma D-dimer level,serum cystatin C level as compared with the non-CTRCD group(P<0.05).The results of multivariate Logistic regression analysis revealed that serum cystatin C level,plasma D-dimer level,and RDW-SD were the independent risk factors for patients with primary NSCLC suffering from CTRCD after PD-1/PD-L1 inhibitors therapy(P<0.05).The results of ROC analysis indicated that areas under the curve of serum cystatin C level,plasma D-dimer level,and RDW-SD in predicting patients with primary NSCLC suffering from CTRCD after receiving PD-1/PD-L1 inhibitors therapy were 0.711,0.774,0.687,respectively,and area under the curve of the combined prediction of the three was 0.808.Conclusion Serum cystatin C level,plasma D-dimer level,and RDW-SD are the independent risk factors for patients with primary NSCLC suffering from CTRCD after receiving PD-1/PD-L1 inhibitors therapy,and the combined detection of the three exerts relatively favorable predictive values on these patients suffering from CTRCD.关键词
原发性非小细胞肺癌/肿瘤治疗相关心功能不全/程序性细胞死亡蛋白1/程序性细胞死亡蛋白配体1/危险因素/预测效能Key words
Primary non-small cell lung cancer/Cancer treatment-related cardiac dysfunction/Programmed death 1/Programmed death ligand 1/Risk factors/Prediction efficiency分类
医药卫生引用本文复制引用
王传统,徐露露,张瑞,杨军..原发性非小细胞肺癌患者PD-1/PD-L1抑制剂治疗后发生肿瘤治疗相关心功能不全的危险因素[J].广西医学,2023,45(19):2310-2314,2342,6.基金项目
山东省自然科学基金(ZR2022MH151,ZR2022QH237) （ZR2022MH151,ZR2022QH237）
