摘要
Abstract
Objective:To explore distribution characteristics of PD-1 on surface of peripheral blood T cells in non-small cell lung cancer(NSCLC)and its relationship with efficacy of interventional therapy.Methods:A total of 100 NSCLC patients who under-went interventional treatment in Rugao People's Hospital from February 2018 to October 2022 were selected as study subjects and set as case group,and 100 healthy individuals who underwent physical examinations at Rugao People's Hospital during same period as control group 1,another 100 patients with benign lung disease were set as control group 2.Hierarchical regression model was used to analyze relationship between surface PD-1 expression rate of peripheral blood T lymphocytes and clinical pathological characteristics.Generalized linear mixed model(GLMM)was constructed to determine relationship between PD-1 expression rate on peripheral blood T cell surface and risk of clinical ineffectiveness.Restricted cubic splines(RCS)was used to analyze dose-response relationship be-tween PD-1 expression rate on peripheral blood T cell surface and risk of clinical ineffectiveness.Cox regression analysis was used to identify risk factors.Results:Compared with control group,case group had higher expression rate of PD-1 on surface of CD4+T and CD8+T cells in peripheral blood(P<0.05).PD-1 expression rate of on surface of CD4+T and CD8+T cells in peripheral blood of NSCLC patients were significantly correlated with TNM staging,lymph node metastasis and distant metastasis(P<0.05).Stratified regression model analysis showed that TNM staging,lymph node metastasis and distant metastasis had significant impact on PD-1+CD4+T and PD-1+CD8+T cells(P<0.05).Interventional therapy showed good clinical efficacy,with total effective rate of 76.00%.As therapeutic effect decreased,expression rate of PD-1 on surface of CD4+T and CD8+T lymphocytes in patients with different therapeutic effects showed an increasing trend before and after treatment(P<0.05).After adjusting for confounding factors(Model 2),PD-1+CD4+T value of 15.82～19.43,and≥19.44 clinical ineffectiveness risk were 1.164 and 1.330 times higher than those of control group(<12.20%),respectively(P<0.05);risk of clinical ineffectiveness with PD-1+CD8+T ranging from 17.06～20.69,and≥20.70 was 1.162 and 1.313 times higher than control group(<13.42%),respectively(P<0.05).RCS analysis showed a non-linear relationship between continuous changes in PD-1+CD4+T and PD-1+CD8+T and clinical failure risk(all P<0.001).Cox regression analysis showed that distant metastasis,PD-1+CD4+T and PD-1+CD8+T were all independent influencing factors for postoperative OS(P<0.05);TNM staging,distant metastasis and number of interventions were all independent influencing factors for postoperative PFS(P<0.05).Conclusion:PD-1 expression rate on surface of CD4+T and CD8+T cells in peripheral blood of NSCLC patients is significantly correlated with TNM staging,lymph node metastasis,distant metastasis,clinical efficacy of interventional treatment and postoperative OS;PD-1+CD4+T and PD-1+CD8+T levels in TNM stages Ⅲ～Ⅳ are significantly higher than stage Ⅰ～Ⅱ patients.PD-1 expression rate can provide assistance for early diagnosis and auxiliary staging of NSCLC patients and guide clinical treatment.关键词
非小细胞肺癌/程序性细胞死亡蛋白1/T细胞/介入治疗Key words
Non-small cell lung cancer/PD-1/T cell/Interventional therapy分类
医药卫生
