Distribution characteristics of Traditional Chinese Medicine constitution and prognosis analysis in non-small cell lung cancer with different expression levels of PD-L1
10.3760/cma.j.cn115398-20240418-00216
- VernacularTitle:非小细胞肺癌PD-L1不同表达水平患者中医体质分布特点及预后分析
- Author:
Duo WAN
1
;
Zhi WEN
;
Sheng CHEN
;
Zhengyi LIU
;
Yuxiang HU
;
Haozhu WANG
;
Yinhui SUN
;
Tonglin SUN
;
Lihuai WANG
Author Information
1. 湖南中医药大学2022级硕士研究生，长沙 410208
- Keywords:
Non-small cell lung cancer;
Prognosis;
Traditional Chinese medicine constitution;
Immunotherapy
- From:
International Journal of Traditional Chinese Medicine
2025;47(4):449-455
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the different expression levels of programmed cell death 1 ligand 1 (PD-L1) in non-small cell carcinoma (NSCLC) of distribution characteristics of TCM constitutions and prognosis.Methods:The clinical data of 355 NSCLC patients who had been treated with immune checkpoint inhibitors (ICIs) from January 2019 to June 2023 in the Cancer Medical Center of the First Affiliated Hospital of Hunan University of Chinese Medicine were retrospectively analyzed, and their TCM constitutions were determined. According to the expression level of PD-L1, they were divided into three groups: low expression group (TPS≤1%), medium expression group (1% < TPS < 49%) and high expression group (TPS≥50%). Overall survival (OS) of patients was followed up, and the median OS were compared. Kaplan-Meier method was used to draw survival curves, and Log-rank test was used to compare the difference of survival curves. The independent risk factors of OS were analyzed by COX regression.Results:The distribution of different TCM constitutions showed statistical significance across the three groups ( P<0.05). The median OS for the medium and high expression groups were 21.082 months and 25.714 months, respectively, both significantly higher than the 14.437 months for the low expression group ( P<0.05). The survival curve of TCM constitutions showed that the constitutions significantly correlated with the prognosis of ICIs treatment were qi deficiency, phlegm dampness, and blood stasis ( P<0.05 or P<0.01). The median OS from high to low was 44.971 months for phlegm-dampness constitution, 23.297 months for qi-deficiency constitution, and 11.763 months for blood-stasis constitution. COX regression analysis indicated that medium PD-L1 expression ( HR=0.622, 95% CI=0.459,0.844, P=0.002), high PD-L1 expression ( HR=0.509, 95% CI=0.361,0.718, P<0.001), phlegm-dampness constitution ( HR=0.556, 95% CI=0.335,0.924, P=0.024), and blood-stasis constitution ( HR=2.952, 95% CI=1.929,4.518, P<0.001) were independent prognostic factors. Conclusions:The higher the expression level of PD-L1 in NSCLC patients, the better the prognosis of ICIs treatment. The prognosis of ICIs treatment is better for people with phlegm-dampness constitution and poor for those with blood stasis constitution.
