| Objective: To detect the expression level of V-domain Ig suppressor of T cell activation(VISTA)in lung tumor tissue and the Neutrophil-to-lymphocyte ratio(NLR)in peripheral blood,analyze their association with clinicopathological characteristics and effects on lung cancer prognosis,and explore their significance as the potential markers of lung cancer clinical prognosis.Methods: According to the criteria of the research design,114 patients with lung cancer who were surgically resected and diagnosed by histopathology at the Second Affiliated Hospital of Nanhua University from December 2013 to December 2017 were selected as the study objects,and their clinicopathological datum,follow-up datum and paraffin embedded lung tissue samples were collected.Immunohistochemical SP method was employed to detect the expression level of VISTA in lung cancer tissue and adjacent tissue.According to the double-scoring semi-quantitative method and the receiver operating curve(ROC)to obtain the best cut-off value of VISTA expression and NLR,the study subjects were divided into low expression group and high expression group,low NLR group and high NLR group,respectively.Chi-square test or Fisher exact probability method was used to detect the correlation between VISTA expression and NLR and clinicopathological characteristics.The Kaplan-Meier method was employed to draw the survival curve to analyse the effects of VISTA expression and NLR on overall survival(OS)and disease free survival(DFS)respectively,then Cox regression analysis was done to comprehensively evaluate the effects of VISTA expression and NLR on lung cancer prognosis.Result:1.VISTA high expression in lung cancer cells had no significant difference in age,drinking,hypertension history,diabetes history,clinical T staging,clinical N staging,clinical M staging and TNM staging(P>0.05).2.VISTA high expression in interstitial lymphocytes had no significant difference in age,drinking,hypertension history,diabetes history,clinical T staging,clinical N staging,clinical M staging and TNM staging(P>0.05).3.There were statistically significant differences of high NLR in clinical T staging(χ~2=7.824,P=0.008),clinical N staging(χ~2=6.871,P=0.042),and clinical TMN staging(χ~2=6.003,P=0.033).There were no statistically significant differences in gender,age,smoking,drinking,hypertension history,diabetes history,M staging and histological subtype(P>0.05).4.The prognostic analysis of VISTA expression and NLR showed that disease-free survival and overall survival were significantly reduced in lung cancer cell VISTA high expression group(median survival time: 23 months VS 35 months,HR=3.206,95%CI: 2.066-4.975,P<0.01;median survival time: 13 months VS 32 months,HR=3.560,95%CI: 2.333-5.433,P<0.01),interstitial lymphocyte VISTA high expression group(median survival time: 22 months VS 35 months,HR=2.840,95%CI: 1.809-4.458,P<0.01;median survival time: 12 months vs 31 months,HR=2.867,95%CI: 1.840-4.468,P<0.01),VISTA co-expression group of lung cancer cells and interstitial lymphocytes(median survival time: 22 Month VS 35 months,HR=2.983,95%CI: 1.895-4.696,P<0.01;Median survival time:12 months VS 32 months,HR=3.069,95%CI: 1.960-4.806,P<0.01),high NLR group(Median survival time: 18 months VS 40 months,HR=7.634,95%CI: 4.755-12.26,P<0.01;Median survival time: 10 months VS 35 months,HR=6.970,95%CI: 4.358-11.15;P <0.01),high NLR and lung cancer tumor cell VISTA high expression group(median survival time:18months vs 37 months,HR=4.965,95%CI: 2.966-8.229,P<0.01;median survival time: 10 months vs 32 months,HR=4.960,95%CI: 2.995-8.215,P<0.01).5.Multivariate analysis showed that hypertension history(HR=1.883,95%CI: 1.063-3.338,P=0.030),clinical M staging(HR=1.694,95%CI:1.839-74.369,P=0.009),interstitial lymphocytes VISTA expression in lung cancer(HR=4.275,95%CI: 1.589-11.496,P=0.004),high NLR(HR=33.434,95%CI: 10.827-103.244,P<0.01)were are independent prognostic risk factors for lung cancer DFS.Conclusion: High NLR is related to clinical T staging,clinical N staging,and clinical TNM staging;overall survival of lung cancer has nothing to do with high NLR and VISTA expression;history of hypertension,clinical M staging,high expression of VISTA in interstitial lymphocytes,and high NLR are independent prognostic risk factors for lung cancer DFS. |
