Erken Evre Küçük Hücreli Dışı Akciğer Kanseri Hastalarında Serum sPD-1 ve sPD-L1 Düzeylerinin Klinik, Patolojik Özellikler Ve Lenf Nodu Metastazı İle Korelasyonu

Abstract

Cancer is an important health issue, with rapidly increasing incidence and mortality worldwide. Significant advances have been achieved in cancer immunotherapy with the discovery of antigens that enable cancer cells to be recognized by the immune system and to be differentiated from normal cells. Tumor cells and cells in the tumor microenvironment express high amounts of Programmed Cell Death Ligand 1 (PD-L1). These PD-L1s interact with Programmed Cell Death Protein 1 (PD-1), causing immunosuppression. Today, studies have been conducted showing that serum levels of soluble forms of PD-1 (sPD-1) and PD-L1 (sPD-L1) can be biomarkers that can facilitate diagnosis and can be used for predicting prognosis of tumors, and the number of these studies is rapidly increasing. Lung cancer is the most common type of diagnosed cancer with the highest mortality. In non-small cell lung cancer, tumor cells and cells in the tumor microenvironment express high amounts of PD-L1. The aim of our study was to demonstrate the correlation of serum sPD-1 and sPD-L1 levels with clinical and pathological characteristics and lymph node metastasis by measuring their levels in patients with early-stage non-small cell lung cancer, and to compare preoperative serum sPD-1 and sPD-L1 levels with the post-resection values. Moreover, it was also studied whether there was a significant difference between patients with non-small cell lung cancer and patients without cancer in terms of serum sPD-1 and sPD-L1 levels. Our study included 37 non-small cell lung cancer patients as the patient group and 15 benign lung cancer patients as the control group. The preoperative sPD-1 (p=0.001) and sPD-L1 (p=0.001) values of the patient group were statistically significantly higher than those of the control group. There was a statistically significant decrease in serum levels of sPD-1 (p=0.007) and sPD-L1 (p=0.001) on the postoperative days 1, 7 and 30 during the one-month follow-up after surgical resection. There was a significant positive correlation between the preoperative and postoperative 30-day serum sPD-1 values and tumor size. The preoperative sPD-1 level was higher in T2 tumors than in T1 tumors (p=0.025). The preoperative sPD-L1 level increased as the T category increased (p=0.035). The pre-surgical resection sPD-L1 value of those with pleural invasion was significantly higher compared to those without invasion (p=0.001). Whereas, the sPD-1 values of those with pleural invasion were almost statistically significantly higher than the values of the group without invasion (p=0.088). The preoperative sPD-L1 values increased as the N category increased (p=0.043). In the T2 category, the postoperative 30-day PD-1 level was higher compared to T1 category (p=0.024). The postoperative 30-day sPD-L1 value of those with pleural invasion was higher compared to those without invasion (p=0.001). The postoperative 30-day sPD-L1 value increased as the N category increased (p=0.034). In the literature, there is no study demonstrating the correlation of serum sPD-1 and sPD-L1 levels with clinical and pathological characteristics and lymph node metastasis in patients with early-stage non-small cell lung cancer and comparing the pre- and post-surgical resection values of sPD-1 and sPD-L1. Despite the limited sample size of our study, in the light of these results, we are of the opinion that sPD-1 and sPD-L1 can be used as a biomarker for lung cancer screening, prediction of its stage and follow-up for postoperative local recurrence or metastasis, and may economically contribute to our country.