分析受体相互作用蛋白激酶2(receptor interacting protein kinase 2, RIPK2)、程序性细胞死亡1(programmed death-1, PD-1)表达对肺癌患者免疫疗法预测意义。

选取2020年1月至2024年12月我院接受免疫治疗的79例肺癌患者，根据随访结果疗效显著52例为观察组，疗效不佳或死亡27例为对照组。收集患者临床资料；实时定量反转录聚合酶链式反应(reverse transcription-polymerase chain reaction, RT-PCR)检测RIPK2、PD-1 mRNA表达；免疫组化检测RIPK2、PD-1蛋白表达。

肺癌组织RIPK2 mRNA(1.62±0.37比1.00±0.24)、PD-1 mRNA(1.38±0.34比1.00±0.19)、RIPK2蛋白高表达率(72.15%比51.90%)及PD-1蛋白高表达率(69.62%比53.16%)均显著高于癌旁组织(P<0.05)。观察组与对照组在美国东部肿瘤协作组体能状态评分(eastern cooperative oncology group, ECOG)、肿瘤最大径、表皮生长因子受体(epidermal growth factor receptor, EGFR)突变、转移部位数目、肝转移、治疗线数差异有统计学意义(P<0.05)。对照组最大标准化摄取值(standardized uptake value max, SUVmax)(10.34±1.89)、代谢肿瘤体积(metabolic tumor volume, MTV)(22.87±4.85)cm³、病灶总糖酵解量(total lesion glycolysis, TLG)(96.14±11.64) g/ml及腹部CT异常比例70.37%高于观察组(6.15±1.76)、(16.29±4.41) cm³、(80.35±10.32) g/ml、19.23%(P<0.05)。观察组RIPK2 mRNA(1.45±0.32)、PD-1 mRNA(1.18±0.34)、RIPK2蛋白高表达率63.46%、PD-1高表达率59.62%低于对照组(1.98±0.41)、(1.83±0.49)、88.89%、88.89%(P<0.05)。受试者工作特征曲线(receiver operating characteristic curve, ROC)分析显示，RIPK2 mRNA、PD-1 mRNA及联合预测疗效的曲线下面积(area under curve, AUC)分别为0.888、0.877、0.952(P<0.05)。RIPK2高表达者生存率(28.57%比42.86%)及无进展生存率(16.67%比25.00%)、PD-1高表达者生存率(33.33%比40.00%)及无进展生存率(20.83%比22.00%)显著低于低表达者(P<0.05)。

RIPK2与PD-1高表达联合影像学代谢参数可预测肺癌免疫治疗疗效及预后，低表达患者生存获益更佳。

To analyze the predictive significance of receptor interacting protein kinase 2 (RIPK2) and programmed death-1 (PD-1) expression in the efficacy of immunotherapy for lung cancer patients.

Seventy-nine lung cancer patients receiving immunotherapy at Cangzhou People′s Hospital from January 2020 to December 2024 were selected. Clinical data were collected; RIPK2 and PD-1 mRNA expression levels were detected by quantitative real time polymerase chain reaction; RIPK2 and PD-1 protein expression levels were measured by immunohistochemistry; therapeutic efficacy was evaluated. Based on follow-up results, 52 patients were classified as effective (significant efficacy) and 27 as ineffective (poor efficacy or death).

RIPK2 mRNA (1.62±0.37 vs. 1.00±0.24), PD-1 mRNA (1.38±0.34 vs. 1.00±0.19), RIPK2 protein high-expression rate (72.15% vs. 51.90%), and PD-1 protein high-expression rate (69.62% vs. 53.16%) in lung cancer tissues were significantly higher than those in adjacent tissues (P<0.05). Significant differences were observed between effective and ineffective groups in eastern cooperative oncology group (ECOG) score, maximum tumor diameter, epidermal growth factor receptor (EGFR) mutation, number of metastatic sites, liver metastasis, and treatment line (P<0.05). The ineffective group exhibited higher standardized uptake value max (SUVmax) (10.34±1.89 vs. 6.15±1.76), metabolic tumor volume (MTV) (22.87±4.85 vs. 16.29±4.41 cm³), total lesion glycolysis (TLG) (96.14±11.64 vs. 80.35±10.32 g/ml), and abdominal CT abnormality rate (70.37% vs. 19.23%) compared to the effective group (P<0.05). RIPK2 mRNA (1.45±0.32 vs. 1.98±0.41), PD-1 mRNA (1.18±0.34 vs. 1.83±0.49), and protein high-expression rates (RIPK2: 63.46% vs. 88.89%; PD-1: 59.62% vs. 88.89%) in the effective group were lower than those in the ineffective group (P<0.05). Receiver operating characteristic curve (ROC) analysis revealed area under curve (AUC) values of 0.888, 0.877, and 0.952 for RIPK2 mRNA, PD-1 mRNA, and their combination in predicting efficacy, respectively (P<0.05). Patients with high RIPK2 expression showed significantly lower survival rates (28.57% vs. 42.86%) and progression-free survival rates (16.67% vs. 25.00%), while those with high PD-1 expression had lower survival rates (33.33% vs. 40.00%) and progression-free survival rates (20.83% vs. 22.00%) compared to low-expression groups (P<0.05).

High expression of RIPK2 and PD-1 combined with imaging metabolic parameters can predict the efficacy and prognosis of immunotherapy in lung cancer, with patients exhibiting low expression achieving better survival benefits.