目的: 本文主要想通过研究 NSCLC 患者外周血中 sPD-L1、 CXCL9、 SDR5、 MMP-9、 PD-L1以及 IFN-γ等蛋白质的表达水平，并评估其差异与临床特征、预后生存的相关性，评价其是否可以作为辅助诊断、预测疗效和生存的指标。方法:选取 2012 年后于北京协和医院就诊为非小细胞肺癌并住院行一线化疗的患者，不伴有 EGFR 及 ALK 的基因突变共 102 例进行分析，留取一线化疗前血液标本用于检测。102 例患者中腺癌 50 例，鳞癌患者 52 例。临床分型均为 III 期或 IV 期。平均确诊年龄 61.5±9.6 岁。所有患者血液标本均采用酶联免疫吸附测定其中蛋白质水平。所有患者均进行电话随访，统计随访状态，若进展或死亡，则统计第一次病情进展时间，死亡时间。使用 SPSS 22.0 进行数据分析，Graghpad prism 7.0 进行绘图。采用独立样本 t 检验、 Pearson 相关性分析、 Kaplan-Meier 单因素分析、 COX回归分析数据。结果:1.非小细胞肺癌患者的外周血中sPD-L1的表达水平与病理分型、性别、确诊年龄、吸烟情况、LDH水平无明显相关性。与临床分期有一定相关性。同时外周血中sPD-L1水平的高低与NSCLC患者的预后无显著相关性。2.NSCLC患者外周血中的CXCL9的表达水平与患者的年龄、性别等均无明显相关性。但与OS呈正相关，CXCL9的表达越高，患者的总生存期则会延长。3.NSCLC患者外周血中的MMP9表达水平与患者的年龄、性别、病理类型无明显相关性，与肿瘤是否存在淋巴结受累相关，与患者的生存预后无显著相关。4.NSCLC患者外周血中的PD-L1、sDR5、以及IFN-γ的表达水平与患者的临床特征以及生存预后无显著相关性。5.NSCLC患者的外周血中的LDH水平与患者的OS存在显著相关性。LDH升高是NSCLC患者的预后不良因素。结论:在本次研究中，非小细胞肺癌患者外周血中的 sPD-L1 的表达水平与预后无显著相关性，CXCL9 的水平与总生存期相关，MMP9 与肿瘤是否存在淋巴结受累相关。LDH 与患者的预后存在显著相关性。可以认为是 NSCLC 患者的预后不良因素。

OBJECTIVE: TO calculate the expression of sPD - L1, CXCL9, SDR5, MMP-9, PD-L1 and IFN-γ in the peripheral blood of NSCLC patients.To assess the relations between clinical features, prognosis of survival with these proteins To evaluate whether these can be used as predictive biomarkers to know thesurvival.METHODS:A total of 102 patients who were diagnosed with NSCLC in Peking Union Medical College Hospital and untreated are include into the research. These patients don’t get EGFR and ALK mutations.Get their peripheral blood before their first-line chemotherapy. Of these 102 patients, 50 with adenocarcinoma and 52 with squamous cell carcinoma. These patients were classified to stage III or IV according to the criteria. The average age was 61.5 + 9.6 years. The concentrations of proteins were determined by enzyme-linked immunosorbent assay.All patients were followed up by telephone. We need to know the Proggress Free Survival and Overall Ourvival.Data analysis was performed using SPSS 22.0 and graphed by Graghpad prism 7.0. We use different ways such as Independent sample t test, Pearson correlation analysis, kaplan-meier univariate analysis, COX regression analysis to analysis the data.RESULTS:1. The expression of spd-l1 in peripheral blood of patients with NSCLC was not significantly correlated with pathological classification, gender, age of diagnosis, smoking status and LDH level. It is related to clinical stage. Meanwhile, the expression of spd-l1 in peripheral blood was not significantly correlated with the prognosis of NSCLC patients.2. The expression of CXCL9 in peripheral blood of NSCLC patients was not significantly correlated with the age and gender of patients. However, it was positively correlated with OS, and the higher the expression of CXCL9, the longer the overall survival period of patients would be.3. The expression of MMP9 in the peripheral blood of NSCLC patients was not releted with age, gender, pathological types, survival prognosis of patients. The expression may be related to the presence of lymph node.4. The expressions of pd-l1, sDR5, and IFN-γ in peripheral blood of NSCLC patients are not significantly correlated with the clinical characteristics and survival prognosis of patients.5. The value of LDH in peripheral blood of NSCLC patients was significantly correlated with the patient's Overall survival. Maybe LDH can be used as an adverse prognostic factor in NSCLC patients.CONCLUSIONS:In this study, the expression of sPD - L1 in these patients with non-small cell lung cancer was no significantly correlated with the prognosis, CXCL9 is associated with overall survival, MMP9 is associated with r presence of lymph node.LDH is significantly correlated with prognosis of patients.It can be considered as an predictive factor in NSCLC patients.