胃癌患者术后较高的血浆 EV-PD-L1 预示着较差的生存。

Higher postoperative plasma EV PD-L1 predicts poor survival in patients with gastric cancer.

机构信息

Department of hepatobiliary surgery, Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Tongji Medical College, Huazhong University of Science and Technology, Taiyuan, China.

Laboratory of Tumor and Immunology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health (NCCH), Beijing, China.

出版信息

J Immunother Cancer. 2021 Mar;9(3). doi: 10.1136/jitc-2020-002218.

BACKGROUND

The satisfactory prognostic indicator of gastric cancer (GC) patients after surgery is still lacking. Perioperative plasma extracellular vesicular programmed cell death ligand-1 (ePD-L1) has been demonstrated as a potential prognosis biomarker in many types of cancers. The prognostic value of postoperative plasma ePD-L1 has not been characterized.

METHODS

We evaluated the prognostic value of preoperative, postoperative and change in plasma ePD-L1, as well as plasma soluble PD-L1, in short-term survival of GC patients after surgery. The Kaplan-Meier survival model and Cox proportional hazards models for both univariate and multivariate analyzes were used. And the comparison between postoperative ePD-L1 and conventional serum biomarkers (carcinoembryonic antigen (CEA), cancer antigen 19-9 (CA19-9) and CA72-4) in prognostic of GC patients was made.

RESULTS

The prognostic value of postoperative ePD-L1 is superior to that of preoperative ePD-L1 on GC patients after resection, and also superior to that of conventional serum biomarkers (CEA, CA19-9 and CA72-4). The levels of postoperative ePD-L1 and ePD-L1 change are independent prognostic factors for overall survival and recurrence free survival of GC patients. High plasma level of postoperative ePD-L1 correlates significantly with poor survival, while high change in ePD-L1 level brings the significant survival benefit.

CONCLUSIONS

The level of plasma postoperative ePD-L1 could be considered as a candidate prognostic biomarker of GC patients after resection.

背景

目前对于胃癌（GC）患者手术后的满意预后指标仍缺乏共识。研究表明，围手术期血浆细胞外囊泡程序性细胞死亡配体 1（ePD-L1）可作为多种癌症的潜在预后生物标志物。但术后血浆 ePD-L1 的预后价值尚未得到明确。

方法

本研究评估了术前、术后和血浆 ePD-L1 变化对 GC 患者手术后短期生存的预后价值。采用 Kaplan-Meier 生存模型和单因素及多因素 Cox 比例风险模型进行分析。并比较了术后 ePD-L1 与传统血清标志物（癌胚抗原（CEA）、糖类抗原 19-9（CA19-9）和 CA72-4）在 GC 患者预后中的差异。

结果

与术前 ePD-L1 相比，术后 ePD-L1 对 GC 患者的预后价值更高，也优于传统血清标志物（CEA、CA19-9 和 CA72-4）。术后 ePD-L1 水平和 ePD-L1 变化是 GC 患者总生存和无复发生存的独立预后因素。高术后血浆 ePD-L1 水平与生存不良显著相关，而 ePD-L1 水平的高变化则带来显著的生存获益。