【摘要】 目的：探讨CD4~+T/CD8~+T、壳多糖酶3样蛋白1(CHI3L1)、细胞外基质金属蛋白酶诱导因子（CD147）联合预测非小细胞肺癌（NSCLC）患者吉西他滨联合顺铂（GP）化疗预后价值。方法：选取2020年4月至2022年4月南阳市中心医院收治的180例中晚期NSCLC患者，随访2年，记录患者生存率，据此分为生存预后良好组和预后不良组。统计并比较两组人口学特征、临床病理学特征及CD4~+T/CD8~+T、CHI3L1、CD147表达，采用Logistic回归方程分析中晚期NSCLC患者GP化疗生存预后影响因素，绘制受试者工作特征（ROC）曲线及曲线下面积（AUC）分析CD4~+T/CD8~+T、CHI3L1、CD147的预测效能。结果：(1)随访2年，共有3例失访，生存率为77.40%；(2)与生存预后良好组比较，生存预后不良组肿瘤直径较大，CD4~+T、CD4~+T/CD8~+T较低，CD8~+T、CHI3L1、CD147含量及Ⅳ期、中低分化程度、淋巴结转移、远处转移占比较高（P<0.05）；(3)CD4~+T/CD8~+T、CHI3L1、CD147、远处转移是NSCLC患者GP化疗预后的影响因素（P<0.05）；(4)CD4~+T/CD8~+T、CHI3L1、CD147联合预测NSCLC患者GP化疗预后效能优于单一预测效能。结论：CD4~+T/CD8~+T、CHI3L1、CD147是NSCLC患者GP化疗预后影响因素，三者联合对于生存预后预测及确定合理诊治方案具有积极意义。更多还原

【Abstract】 Objective:To explore the prognostic value of combining CD4~+T/CD8~+T, chitinase 3-like protein 1(CHI3L1), and extracellular matrix metalloproteinase inducer(CD147) in predicting prognosis of gemcitabine and cisplatin(GP) chemotherapy in patients with non-small cell lung cancer(NSCLC). Methods:A total of 180 patients with advanced NSCLC from April 2020 to April 2022 were selected from Nanyang Central Hospital and followed up for 2 years, whose survival rates were recorded, and were divided into good survival prognosis group and poor survival prognosis group accordingly. Demographic and clinical pathological characteristics, as well as expression levels of CD4~+T/CD8~+T, CHI3L1 and CD147 were statistically compared between the two groups. Logistic regression equations were used to analyze the factors affecting survival prognosis of patients with advanced NSCLC undergoing GP chemotherapy. Receiver operating characteristic(ROC) curve and area under the curve(AUC) were plotted to evaluate the predictive performance of CD4~+T/CD8~+T, CHI3L1 and CD147. Results:(1) During a 2-year follow-up, 3 cases were lost to follow-up, with a survival rate of 77.40%；(2)Compared with the group with good survival prognosis, group with poor survival prognosis had larger tumor diameters, lower CD4~+T, CD4~+T/CD8~+T, and higher levels of CD8~+T, CHI3L1, CD147, and a higher proportion of stage Ⅳ, moderate to low differentiation, lymph node metastasis, and distant metastasis(P<0.05)；(3)CD4~+T/CD8~+T, CHI3L1, CD147, and distant metastasis were prognostic factors for GP chemotherapy in patients with NSCLC(P<0.05)；(4)Combined efficacy of CD4~+T/CD8~+T, CHI3L1 and CD147 in predicting the prognosis of NSCLC patients was better than the single prediction efficacy. Conclusion:CD4~+T/CD8~+T, CHI3L1 and CD147 are prognostic factors for GP chemotherapy in NSCLC patients. The combination of these three markers holds positive significance for predicting survival prognosis and determining appropriate diagnosis and treatment plans.更多还原