研究概要
ICI治疗引起外周血淋巴细胞亚群百分比的变化,这些变化对脑转移、放疗、EGFR状态、病理及治疗方案具有预后价值,同时对接受ICIs治疗的NSCLC患者也具有预后价值。
研究思路结论见上方概要
背景
本研究的主要目的是探讨外周血淋巴细胞亚群在接受免疫检查点抑制剂(ICIs)治疗的非小细胞肺癌(NSCLC)患者中的预后价值。
方法
2018年至2019年,浙江省肿瘤医院收治的82例诊断为IIIB-IV期NSCLC的患者被纳入本研究。通过流式细胞术分析NSCLC患者ICI治疗前后的外周血淋巴细胞亚群。通过相关性热图、Kaplan-Meier曲线、log-rank检验和Cox回归分析,确定了外周血淋巴细胞亚群百分比与临床病理特征、无进展生存期(PFS)和总生存期(OS)之间的关系。
结果
ICI治疗后CD4/CD8比值和B细胞百分比降低。此外,ICI治疗前CD3+ T细胞、自然杀伤(NK)细胞和自然杀伤T(NKT)细胞的百分比与脑转移相关,ICI治疗前CD3+CD4+ T细胞的比例与表皮生长因子受体(EGFR)状态相关,ICI治疗前CD4/CD8比值与病理相关,ICI治疗前B细胞比例与治疗方案相关,ICI治疗前NKT细胞百分比与放疗使用相关。此外,单因素生存分析显示,低B细胞百分比预示接受ICI治疗的NSCLC患者OS较差。此外,通过外周血淋巴细胞亚群百分比构建的列线图可以判断接受免疫治疗的NSCLC患者的生存概率和生存时间。
展开英文摘要原文
BACKGROUND: The primary aim of this study was to investigate the prognostic value of peripheral blood lymphocyte subsets in non-small cell lung cancer (NSCLC) patients treated with immune checkpoint inhibitors (ICIs).
METHODS: From 2018 to 2019, 82 patients diagnosed with stage IIIB-IV NSCLC at Zhejiang Cancer Hospital were recruited for this study. Peripheral blood lymphocyte subsets of NSCLC patients were analyzed using flow cytometry before and after ICI treatment. The relationship between the percentage of peripheral blood lymphocyte subsets, clinicopathological features, progression-free survival (PFS), and overall survival (OS) was identified by correlation heat map, Kaplan-Meier curve, log-rank test, and Cox regression analysis.
RESULTS: The CD4/CD8 ratio and the percentage of B cells was decreased after ICI treatment. Furthermore, the percentage of CD3 + T cells, natural killer (NK) cells, and natural killer T (NKT) cells before ICI treatment was associated with brain metastases, the proportion of CD3 + CD4 + T cells before ICI treatment was related to epidermal growth factor receptor (EGFR) status, the CD4/CD8 ratio before ICI treatment was correlated to pathology, the ratio of B cells before ICI treatment was related to therapeutic regimen, and the percentage of NKT cells before ICI treatment was associated with use of radiotherapy. Furthermore, univariate survival analysis revealed that low percentage of B cells forecasted a poor OS for NSCLC patients with ICI treatment. In addition, the nomogram developed by percentages of peripheral blood lymphocyte subsets could determine survival probability and survival time of NSCLC patients with immunotherapy.
CONCLUSIONS: ICI treatment induced changes in the percentage of peripheral blood lymphocyte subsets, which had prognostic value for brain metastases, radiotherapy, EGFR status, pathology, and therapeutic regimen, along with prognostic value, for NSCLC patients treated with ICIs.
论文信息
- 作者
- Xu X、Wang D、Chen W、Li N、Suwinski R、Rossi A、Rosell R、Zhong J
- 第一作者单位
- Key Laboratory of Head & Neck Cancer Translational Research of Zhejiang Province, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, China.China
- 通讯作者单位
- Institute of Cancer and Basic Medicine (IBMC), Chinese Academy of Sciences, Hangzhou, China.China
- 期刊
- Translational lung cancer research2021 Dec