Correlation Study Between Plasma SPD-L1 And The Efficacy And Prognosis Of Patients With Non-small Cell Lung Cancer

Objective:To investigate the relationship between the expression of soluble programmed death-ligand 1(s PD-L1)and the clinical features of patients with non-small cell lung cancer(NSCLC).To observe whether the dynamic changes of soluble PD-L1 before and after treatment is related to the clinical efficacy and EGFR gene status.Methods:176 patients who were newly diagnosed as NSCLC by pathology in Shanxi Cancer Hospital from April 2014 to January 2017 were enrolled,12 cases of benign lung lesions.There were 73 healthy people selected as control group.The levels of soluble PD-L1 in plasma of three groups were detected by ELISA,the expression of s PD-L1 before and after treatment was measured and EGFR gene was detected by ARMS in lung cancer group,observing the correlation between the changes of s PD-L1 and clinical efficacy and EGFR gene status.The patients were followed up to analyze the relationship between s PD-L1 expression and prognosis.Results:The expression of soluble PD-L1 in plasma for patients with non-small cell lung cancer was higher than that in benign lung disease group and healthy control group(3.18±2.04ng/ml,1.36±1.02ng/ml and 1.67±0.38ng/ml respectively.P<0.05).The expression of s PD-L1 was not correlated with gender,age,smoking status,pathological type,tumor stage and metastasis(P>0.05).The level of soluble PD-L1 in patients with disease controlled after 2,4 cycles treatment was lower than that before (1.22ng/ml vs 1.09ng/ml;1.61ng/ml vs 0.87ng/ml respectively,P<0.05).The expression of soluble PD-L1 in progression disease group is higher than that in disease controlled group with no statistically significant(1.23ng/ml vs1.09ng/ml;1.17ng/ml vs 0.87ng/ml respectively,P>0.05).The level of soluble PD-L1 in patients with EGFR mutation(exon 19 deletions and exon 21 point mutations)was significantly higher than that in wild type(4.08±2.29ng/ml vs 2.71±1.74ng/ml,P=0.001).The level of soluble PD-L1 was lower than that before treatment for patients with EGFR mutation(2.46ng/ml vs1.69ng/ml,P=0.028),but not for wild type.The level of soluble PD-L1 was significantly lower than that in patients with EGFR mutation treated with EGFR-TKI(2.61ng/ml vs 1.19ng/ml,P=0.023),but there was no significant difference between patients before and after chemotherapy(P=0.622).The OS was higher in the low expression of soluble PD-L1 group(28.0months vs12.0months,P <0.001),but there was no significant difference in PFS(9.0months vs10.0months,P=0.184).Conclusion:The expression of plasma soluble PD-L1 in patients with NSCLC was higher than that in healthy and benign lung disease patients,the dynamic changes of soluble PD-L1 were related to the clinical efficacy,the mutation status of EGFR affected the expression of soluble PD-L1 in patients with NSCLC,patients with high expression of soluble PD-L1 may have a poor prognosis,indicating that soluble PD-L1 may be used as a molecular marker for predicting the efficacy and prognosis of patients with NSCLC.