血清标志物在评价免疫检查点抑制剂治疗肺癌疗效中的价值。

IF 0.7 4区 医学 Q4 MEDICAL LABORATORY TECHNOLOGY
Yan Chen, Endong Wu, Yifeng Ma, Guangli Shi
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引用次数: 0

摘要

背景:近年来,免疫检查点抑制剂(immune checkpoint inhibitors, ICIs)被广泛应用于肺癌的治疗,并显著提高了患者的生存率。然而,ICIs免疫治疗肺癌患者的获益率仅为15 - 40%。为实现肺癌的准确免疫治疗,有必要寻找有效可靠的疗效评价生物标志物。因此,本研究的目的是分析通过检测血清神经元特异性烯醇化酶(NSE)、前胃泌素释放肽(pro-GRP)、细胞角蛋白19片段(Cyfra21-1)、鳞状细胞癌抗原(SCC)、癌胚抗原(CEA)在肺癌患者接受ICIs治疗中的疗效评价价值。方法:采用流式荧光法检测肺癌患者免疫治疗前后血清NSE、pro-GRP、Cyfra21-1、SCC、CEA水平。结果:ICIs免疫治疗2个周期后,部分缓解患者血清NSE、pro-GRP、Cyfra21-1、SCC、CEA水平下降,差异有统计学意义(p < 0.05)。病情稳定患者血清Cyfra21-1、CEA、SCC水平显著降低(p < 0.05)。病程进展患者血清NSE、pro-GRP、Cyfra21-1、SCC、CEA水平均显著升高(p < 0.05)。SCLC患者治疗前NSE或pro-GRP阳性百分比显著高于NSCLC患者(p < 0.001)。治疗前NSCLC患者中Cyfra21-1或SCC阳性的百分比显著高于SCLC患者(p < 0.001)。治疗前NSCLC与SCLC患者CEA阳性差异无统计学意义(p < 0.05)。NSE、pro-GRP、Cyfra21-1、SCC、CEA对免疫治疗疗效的敏感性分别为92.3%、84.6%、95.4%、96.7%、81.3%。结论:肺癌患者免疫治疗前后血清NSE、pro-GRP、Cyfra21-1、SCC、CEA水平的变化与治疗效果有关,可用于疗效评价。SCLC患者应选择血清NSE、pro-GRP和CEA评价ICIs免疫治疗的疗效,NSCLC患者应选择血清Cyfra21-1、SCC和CEA评价ICIs免疫治疗的疗效。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Value of Serum Markers in Evaluating the Curative Effect of Immune Checkpoint Inhibitors for Lung Cancer.

Background: In recent years, immune checkpoint inhibitors (ICIs) have been widely used in the treatment of lung cancer, and they significantly improve the survival rate of patients. However, the benefit rate of ICIs immunotherapy for lung cancer patients is only 15 - 40%. It is necessary to find effective and reliable biomarkers for evaluating the curative effect to achieve accurate immunotherapy for lung cancer. Therefore, the objective of this study was to analyze the value of response evaluation through detecting serum neuron-specific enolase (NSE), pro-gastrin-releasing peptide (pro-GRP), cytokeratin 19 fragment (Cyfra21-1), squamous cell carcinoma antigen (SCC), and carcinoembryonic antigen (CEA) in the lung cancer patients treated with ICIs.

Methods: The levels of serum NSE, pro-GRP, Cyfra21-1, SCC, and CEA in the lung cancer patients of pre- and post-immunotherapy with ICIs were detected by flow fluorescence method.

Results: The serum levels of NSE, pro-GRP, Cyfra21-1, SCC, and CEA in the patients with partial remission were decreased after ICIs immunotherapy of 2 cycles, and the difference was statistically significant (p < 0.05). The serum levels of Cyfra21-1, CEA, and SCC in the patients with stable disease were significantly decreased (p < 0.05). The serum levels of NSE, pro-GRP, Cyfra21-1, SCC, and CEA in the patients with disease progression were signi-ficantly increased (p < 0.05). The percentages of positive NSE or pro-GRP in the SCLC patients before treatment were significantly higher than these of NSCLC patients (p < 0.001). The percentages of positive Cyfra21-1 or SCC in the NSCLC patients before treatment were significantly higher than these of SCLC patients (p < 0.001). There was no significant difference between positive CEA in the NSCLC and SCLC patients before treatment (p > 0.05). The sensitivities of NSE, pro-GRP, Cyfra21-1, SCC, and CEA in evaluating the efficacy of immunotherapy were 92.3%, 84.6%, 95.4%, 96.7%, and 81.3%.

Conclusions: The changed levels of serum NSE, pro-GRP, Cyfra21-1, SCC, and CEA in the lung cancer patients in pre- and post-immunotherapy with ICIs were related to the therapeutic effect and may be used for the response evaluation. The SCLC patients should choose serum NSE, pro-GRP, and CEA for the response evaluation of ICIs immunotherapy, and the NSCLC patients should choose serum Cyfra21-1, SCC, and CEA.

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来源期刊
Clinical laboratory
Clinical laboratory 医学-医学实验技术
CiteScore
1.50
自引率
0.00%
发文量
494
审稿时长
3 months
期刊介绍: Clinical Laboratory is an international fully peer-reviewed journal covering all aspects of laboratory medicine and transfusion medicine. In addition to transfusion medicine topics Clinical Laboratory represents submissions concerning tissue transplantation and hematopoietic, cellular and gene therapies. The journal publishes original articles, review articles, posters, short reports, case studies and letters to the editor dealing with 1) the scientific background, implementation and diagnostic significance of laboratory methods employed in hospitals, blood banks and physicians'' offices and with 2) scientific, administrative and clinical aspects of transfusion medicine and 3) in addition to transfusion medicine topics Clinical Laboratory represents submissions concerning tissue transplantation and hematopoietic, cellular and gene therapies.
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