Analysis Of The Significance Of Immune-Related Cytokines In The Immunotherapy Of Non-Small Cell Lung Cancer

Objective: We analyzed the correlation between immune-related cytokines and the efficacy of immunotherapy in patients with advanced non-small cell lung cancer(NSCLC)by measuring the levels of immune-related cytokines in serum and pleural fluid,and provided a basis for the treatment of NSCLC patients.Methods: Forty-five patients with unresectable advanced NSCLC who underwent immunotherapy in Affiliated Hospital of Inner Mongolia Medical University from December 2021 to February 2023 were selected for the study,and were divided into disease control and disease progression groups according to the evaluation criteria of immune efficacy of solid tumors,and serum IL-2,IL-4,IL-6,IL-10,TNF-a,and IFN-γ,IL-17 levels,to analyze the predictive value of serum cytokine levels and their changes on the efficacy of immunotherapy in patients with NSCLC.Twenty patients with advanced NSCLC combined with malignant pleural effusion(MPE)who were seen in our hospital during the same period were divided into disease control group and disease progression group according to the evaluation criteria of immune efficacy of solid tumors.ELISA assay was applied to detect the levels of IL-4,IL-6,IL-10,TNF-a,PD-L1 in the pleural fluid before treatment in both groups to analyze the predictive value of immune-related cytokine levels in pleural fluid on the efficacy of immunotherapy.All data were analyzed using SPSS26.0statistical software.Results:1.Relationship between general information and immunotherapy efficacy in two groups of NSCLC patients: a total of 45 patients with advanced NSCLC were included,and after 2cycles of immunotherapy,i CR+i PR+i SD were categorized as the disease control group(n=33),and patients with i PD were categorized as the disease progression group(n=12).There were no significant differences between the two groups in terms of gender,age,type of pathology,TNM stage,presence or absence of smoking history,and ECOG score(P>0.05).2.The relationship between serum immune-related cytokine levels and immunotherapy efficacy in NSCLC patients: there was no significant difference in IL-2,IL-4,IL-6,IL-10,TNF-a,IFN-γ,IL-17 between the two groups before immunotherapy(P>0.05).After receiving immunotherapy for 2 cycles,the levels of IL-4,IL-6 and IL-10 in the disease progression group were significantly higher than those in the control group,and the difference was statistically significant(P<0.05).In contrast,there was no significant difference in IL-2,IL-17,TNF-a,and IFN-γ levels(P>0.05).3.Relationship between the rate of change of serum cytokines and the efficacy of immunotherapy in two groups of patients before and after immunotherapy: the change rates of IL-4,IL-6 and IL-10 in the disease progression group were significantly greater than those in the disease control group,and the difference was statistically significant(P<0.05).After logistic regression,the results showed that the change rate of IL-4 was correlated with the efficacy of immunotherapy(P<0.05)and was an independent influencing factor of the efficacy of immunotherapy in NSCLC patients.The rate of IL-4 change was evaluated by ROC curves to predict disease progression,yielding a cut-off value of 78.0% for IL-4 rate of change,i.e.,patients reaching this elevation had a sensitivity of 83.33%,a specificity of84.85%,and a Youden’s index of 68.18% for the assessment of disease progression status.4.General information of patients with NSCLC combined with MPE in both groups in relation to the efficacy of immunotherapy: A total of 20 patients with NSCLC combined with MPE were included,and after 2 cycles of immunotherapy,i PR+i SD were categorized as the disease control group(n=11)and patients with i PD were categorized as the disease progression group(n=9).There was no significant difference between the two groups in terms of gender,type of pathology,and ECOG score(P>0.05);there was a significant difference in terms of age(P<0.05).5.Comparison of immune-related cytokines in pleural fluid before treatment between two groups of patients with NSCLC combined with MPE: There were significant differences in the levels of IL-4,IL-6,IL-10,TNF-a,and PD-L1 between patients in the control and progressive groups(P<0.05).The levels of IL-4,IL-6,IL-10,TNF-a,and PD-L1 in the pleural fluid of the progressive group before treatment were higher than those in the control group,suggesting that the levels of IL-4,IL-6,IL-10,TNF-a,and PD-L1 before treatment may have some predictive value for the therapeutic efficacy of advanced NSCLC.Conclusions:1.The rate of IL-4 change during immunotherapy in patients with advanced NSCLC is an independent influence on the efficacy of immunotherapy in NSCLC patients and may be a predictive marker for the efficacy of immunotherapy in NSCLC patients.2.The levels of IL-4,IL-6,IL-10,TNF-a,and PD-L1 in the pleural fluid before immunotherapy in patients with NSCLC combined with MPE may have some predictive value for treatment efficacy.