血清NKG2D和YKL-40表达与NSCLC患者免疫功能的相关性及对其复发的预测价值OA
Association of Serum NKG2D and YKL-40 Expression with Immune Function and Their Predictive Value for Recurrence in Patients with NSCLC
目的 分析非小细胞肺癌(non-small cell lung cancer,NSCLC)患者血清自然杀伤细胞活化受体2D(natural killer group 2 member D,NKG2D)、甲壳质酶蛋白-40(human cartilage glycoprotein-40,YKL-40)表达与免疫功能的关系,并预测其复发的价值.方法 采取回顾性研究,选取2022年11月至2023年11月河南科技大学第一附属医院收治的162例NSCLC患者作为研究对象.出院后随访1年,将162例患者分为复发组44例(27.16%)及未复发组118例(72.84%).比较两组一般资料、血清NKG2D、YKL-40水平;用双变量相关性皮尔逊分析血清NKG2D、YKL-40与免疫功能的相关性;用Logistic回归检验各因素对NSCLC患者复发的影响;绘制受试者工作特征(ROC)曲线,分析血清NKG2D、YKL-40对NSCLC患者复发的预测价值;用R4.1.0统计学软件,以高风险阈值为横坐标、净收益率为纵坐标,绘制血清NKG2D、YKL-40水平预测NSCLC患者复发的决策曲线.结果 双变量相关性皮尔逊分析结果显示,NKG2D与CD8+呈负相关(r<0,P<0.05),与CD4+/CD8+、NK呈正相关(r>0,P<0.05),YKL-40与CD8+呈正相关(r>0,P<0.05),与CD4+/CD8+、NK呈负相关(r<0,P<0.05);经Logistic回归分析显示,YKL-40、CD8+是NSCLC患者复发的危险因素(OR>1,P<0.05);NKG2D、CD4+/CD8+、NK是其保护因素(OR<1,P<0.05);绘制ROC曲线显示,血清NKG2D、YKL-40单独及联合预测NSCLC患者复发的AUC分别为0.753、0.737、0.848;绘制决策曲线,结果显示,在阈值0.070～0.650,0.670～0.733,0.767～0.855范围内,血清NKG2D、YKL-40联合预测NSCLC患者复发的净收益率优于单独的净收益率.结论 NSCLC患者的血清NKG2D、YKL-40表达与免疫功能有较好的相关性,是NSCLC患者复发的影响因素,两项指标联合检测对NSCLC患者复发具有较高的预测价值,可一定程度上指导制定临床治疗策略.
Objective This study aimed to analyze the relationship between serum natural killer cell activating receptor 2D(NKG2D),chitinase protein-40(YKL-40)expression and immune function in patients with non-small cell lung cancer(NSCLC),and to predict the value of recurrence.Methods A retrospective study was conducted to select 162 patients with NSCLC admitted to the hospital from November 2022 to November 2023 as the study subjects.After 1 year of follow-up after discharge,162 patients were divided into 44 cases(27.16%)in the recurrence group and 118 cases(72.84%)in the non-recurrence group.The general data,serum NKG2 D and YKL-40 levels were compared between the two groups.The correlation between serum NKG2D,YKL-40,and immune function was analyzed by bivariate correlation Pearson.Logistic regression was used to test the effect of various factors on the recurrence of NSCLC patients.The receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of serum NKG2 D and YKL-40 for recurrence in patients with NSCLC.R4.1.0 statistical software was used to draw the decision curve of serum NKG2D and YKL-40 levels to predict the recurrence of NSCLC patients with high risk threshold as abscissa and net return rate as ordi-nate.Results NKG2D exhibited a negative correlation with CD8+(r<0,P<0.05),but a positive correlation with both CD4+/CD8+and NK(r>0,P<0.05).YKL-40 exhibited a positive correlation with CD8+(r>0,P<0.05),but a negative correlation with both CD4+/CD8+and NK(r<0,P<0.05).ROC curve showed that the AUC of serum NKG2 D,YKL-40 alone and combined in predicting the recurrence of NSCLC patients were 0.753,0.737,and 0.848.The decision curve was drawn.The results showed that in the range of 0.070～0.650,0.670～0.733,and 0.767～0.855,the net rate of return of serum NKG2D and YKL-40 combined to predict the recur-rence of NSCLC patients was better than that of single net rate of return.Conclusion The expression of serum NKG2D and YKL-40 in patients with NSCLC has a good correlation with immune function,which is an influencing factor for the recurrence of NSCLC patients.The combined detection of the two indicators has a high predictive value for the recurrence of NSCLC patients,which can guide the development of clinical treatment strategies to a certain extent.
肖中岳;乔滨;刘志伟
河南科技大学第一附属医院 胸部肿瘤外科一病区(洛阳 471000)河南科技大学第一附属医院 胸部肿瘤外科一病区(洛阳 471000)河南科技大学第一附属医院 胸部肿瘤外科一病区(洛阳 471000)
医药卫生
非小细胞肺癌自然杀伤细胞活化受体2D甲壳质酶蛋白-40免疫功能复发
Non-small cell lung cancerNKG2DYKL-40Immune functionRecurrence
《西南医科大学学报》 2026 (3)
350-355,6
河南省科技攻关计划项目(252102310095)
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