Correlations between the expressions of PD-L1 and EGFR in the plasma exosomes and clinical features and prognosis in patients with non-small cell lung cancer

doi:10.3760/cma.j.issn.1007-1245.2024.16.010

Abstract

Abstract:

Objective　To detect the expressions of programmed death ligand 1 (PD-L1) and epidermal growth factor receptor (EGFR) in the plasma exosomes in patients with non-small cell lung cancer (NSCLC), and analyze their correlations with clinical features and prognosis. Methods　A total of 312 NSCLC patients treated in Yan'an University Affiliated Hospital from January 2015 to March 2016 were retrospectively selected as the research objects. There were 178 males and 134 females, ≥55 years old in 180 cases and <55 years old in 132 cases, tumor length ≥5 cm in 169 cases and <5 cm in 143 cases. The expressions of exosomal marker proteins CD63, CD81, and TSG101 were detected by Western blot technique, and the expressions of PD-L1 and EGFR in the plasma exosomes were detected by enzyme-linked immunosorbent assay (ELISA). Kaplan-Meier survival curve was used for prognostic analysis. The factors influencing the prognosis of NSCLC patients were analyzed by COX regression analysis. χ² test was used. Results　The PD-L1 and EGFR levels in the plasma exosomes were higher in patients with lower degree of differentiation, lymph node metastasis, and smoking history (all P<0.05). High level of PD-L1 in the plasma exosomes was closely related to high level of EGFR (P<0.05). Among the 312 patients, 27 patients were lost to follow-up, with a follow-up rate of 91.35% (285/312). The 5-year survival rate of the 285 patients was 62.46% (178/285). The survival rate of the patients with high level of PD-L1 was 30.77% (48/156), and that of the patients with low level of PD-L1 was 83.33% (130/156), with a statistically significant difference (log-rank χ²=92.743, P<0.05). The survival rate of the patients with high EGFR level was 20.51% (32/156), and that of the patients with low EGFR level was 93.59% (146/156), with a statistically significant difference (log-rank χ²=119.215, P<0.05). Multifactor analysis showed that high levels of plasma exosome PD-L1 and EGFR expression, lower degree of differentiation, and lymph node metastasis were independent risk factors affecting the prognosis in NSCLC patients (all P<0.05). Conclusion　Plasma exosomal PD-L1 and EGFR expressions are closely associated with disease progression of NSCLC, and can be used as predictors of prognosis.

Key words:

Non-small cell lung cancer, Programmed death ligand 1, Epidermal growth factor receptor, Exosomes, Expression

摘要：

目的　检测非小细胞肺癌（NSCLC）患者血浆外泌体程序性死亡受体配体1（PD-L1）和表皮生长因子受体（EGFR）的表达，并分析二者与临床特征及预后的相关性。方法　回顾性选取2015年1月至2016年3月在延安大学附属医院就诊的NSCLC患者312例作为研究对象，男178例，女134例；年龄≥55岁180例，<55岁132例；肿瘤长径≥5 cm 169例，<5 cm 143例。采用蛋白质免疫印迹技术检测外泌体标志性蛋白CD63、CD81、TSG101的表达情况；采用酶联免疫吸附法（ELISA）检测患者血浆外泌体PD-L1和EGFR水平；采用Kaplan-Meier生存曲线进行预后分析；采用COX回归分析法分析影响NSCLC患者预后的因素；采用χ²检验。结果　分化程度低、有淋巴结转移及吸烟史患者血浆外泌体PD-L1和EGFR水平较高（均P<0.05）；患者血浆外泌体PD-L1高水平与EGFR高水平关系密切（P<0.05）。312例患者中失访27例，随访率为91.35%（285/312）；285例随访患者5年生存率为62.46%（178/285）。PD-L1高水平患者的生存率为30.77%（48/156），PD-L1低水平患者的生存率为83.33%（130/156），差异有统计学意义（log-rank χ²=92.743，P<0.05）。EGFR高水平患者的生存率为20.51%（32/156），EGFR低水平患者的生存率为93.59%（146/156），差异有统计学意义（log-rank χ²=119.215，P<0.05）。多因素分析显示，血浆外泌体PD-L1和EGFR高水平表达、分化程度低、淋巴结转移是影响NSCLC患者预后的独立危险因素（均P<0.05）。结论　血浆外泌体PD-L1和EGFR表达与NSCLC疾病进展密切相关，可作为患者预后的预测指标。

关键词:

非小细胞肺癌, 程序性死亡受体配体1, 表皮生长因子受体, 外泌体, 表达

Bao Hui, Wang Kai, Li Weiwei.

Correlations between the expressions of PD-L1 and EGFR in the plasma exosomes and clinical features and prognosis in patients with non-small cell lung cancer [J]. International Medicine and Health Guidance News, 2024, 30(16): 2682-2686.

鲍慧王凯李伟伟.

血浆外泌体PD-L1和EGFR表达与NSCLC临床特征及预后的相关性 [J]. 国际医药卫生导报, 2024, 30(16): 2682-2686.

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