目的 探究晚期非小细胞肺癌（NSCLC）患者CD39水平与肿瘤浸润T细胞密度的关系及其对卡瑞利珠单抗联合化疗后肿瘤相关性死亡的预测价值。方法 选取2021年1月—2023年1月内蒙古医科大学附属医院收治的晚期NSCLC患者108例作为研究对象。根据患者治疗后2年的生存情况，将患者分为生存组（n＝68）和死亡组（n＝40）。收集患者年龄、性别、吸烟史、饮酒史、糖尿病、肿瘤分化程度、原发肿瘤（T）、区域淋巴结（N）、远处转移（M）（TNM分期）、淋巴结转移、肿瘤直径、病理分类信息，检测患者CD39和肿瘤浸润T细胞水平。比较不同临床病理特征下患者CD39阳性细胞百分比差异；分层回归分析CD39阳性细胞百分比与临床病理特征的关系；多元线性回归分析CD39阳性细胞百分比与浸润T细胞百分比的关系； COX回归分析CD39阳性细胞百分比对患者死亡发生风险的影响并进行亚组分析；受试者工作特征曲线（ROC）分析CD39对患者死亡的预测价值； Kaplan-Meier生存曲线绘制不同CD39阳性细胞百分比水平患者治疗后2年的生存曲线，并采用Log-rank检验进行比较。结果 男性、肿瘤低分化、T₄N₂M₀、腺癌患者CD39阳性细胞百分比高于女性、肿瘤中/高分化、T₄N₀M₀/T₄N₁M₀、鳞状细胞癌/其他病理类型患者，差异具有统计学意义（P＜0.05）。分层回归结果显示，性别（女性）、肿瘤分化程度、病理类型（鳞癌/其他）会对CD39阳性细胞百分比产生负向影响（β＜0，P＜0.05），TNM分期对CD39阳性细胞百分比产生正向影响（β＞0，P＜0.05）。生存组年龄小于死亡组，中/高分化程度、T₄N₀M₀/T₄N₁M₀、肿瘤直径＜3 cm、鳞癌/其他病理类型的人数多于死亡组，CD39阳性细胞百分比、CD8⁺水平低于死亡组，CD3⁺、CD4⁺水平高于死亡组，两组之间的差异具有统计学意义（P＜0.05）。多元线性回归分析结果显示，CD39阳性细胞百分比与CD3⁺、CD4⁺存在负相关关系（β＜0，P＜0.05），与CD8⁺存在正相关关系（β＞0，P＜0.05）。COX回归分析结果显示，CD39阳性细胞百分比与患者死亡存在独立相关性[风险比（HR） ＝1.812，95%置信区间（CI）： 1.246～2.571]。亚组分析结果显示，不同浸润T细胞下CD39阳性细胞百分比与患者死亡的相关性稳定存在。ROC曲线分析结果显示，CD39阳性细胞百分比对患者死亡具有较高的预测价值，敏感度为0.821，特异度为0.835，曲线下面积（AUC）值为0.874。患者总生存率的Kaplan-Meier生存曲线显示，CD39阳性细胞百分比≤17.89%和CD39阳性细胞百分比＞17.89%患者2年的累积生存率分别为75.63%和66.72%，差异具有统计学意义（P＜0.05）。结论 晚期NSCLC患者CD39水平与肿瘤浸润T细胞密度相关，对卡瑞利珠单抗联合化疗后肿瘤相关性死亡具有较高的预测价值，可为晚期NSCLC的治疗提供一定的参考。

Objective To explore the relationship between CD39 levels and tumor-infiltrating T cell density in patients with advanced non-small cell lung cancer (NSCLC), and its predictive value for tumor-related death after camrelizumab combined with chemotherapy. Methods A total of 108 patients with advanced NSCLC admitted to Affiliated Hospital of Inner Mongolia Medical University from January 2021 to January 2023 were selected as the research subjects. According to the survival status of the patients two years after treatment, the patients were divided into the survival group (n = 68) and the death group (n = 40). Collect the patients’ age, gender, smoking history, drinking history, diabetes, degree of tumor differentiation, TNM stage, lymph node metastasis, tumor diameter, pathological classification, and detect the levels of CD39 and tumor-infiltrating T cells in the patients. Compare the differences in the percentage of CD39-positive cells among patients under different clinicopathological characteristics; Stratified regression analysis was conducted to analyze the relationship between the percentage of CD39-positive cells and clinicopathological characteristics; The relationship between the percentage of CD39-positive cells and the percentage of infiltrating T cells was analyzed by multiple linear regression. COX regression was used to analyze the impact of the percentage of CD39-positive cells on the risk of death in patients and subgroup analysis was conducted. The receiver operating characteristic curve (ROC) was used to analyze the predictive value of CD39 for patient mortality. The Kaplan-Meier survival curve was used to draw the survival curves of patients with different percentage levels of CD39-positive cells two years after treatment, and the Log-rank test was used for comparison. Results The percentage of CD39-positive cells in male patients with poorly differentiated tumors, T₄N₂M₀ patients, and adenocarcinoma patients was higher than that in female patients with moderately/well-differentiated tumors, T₄N₀M₀/T₄N₁M₀ patients, squamous cell carcinoma patients, and other pathological types, and the difference was statistically significant (P < 0.05). The stratified regression results showed that gender (female), tumor differentiation degree, and pathological type (squamous cell carcinoma/others) 楨瑡桤?慡搠癮慥湧捡整摩?乥匠????楣獴?捯潮爠牴敨汥愠瑰敥摲?睥楮瑴桡?瑥栠敯?搠敃湄猳椹琭祰?潳晩?瑩當浥漠牣?楬湬晳椠氨璲爠愼琠椰測朠?呩￣捐攼氯汩猾?愼渠搰?栰愵猩?愠?桨楩杬桥?灔牎敍搠楳捴瑡楧癥攠?癡慤氠畡攠?景潳物?瑩當浥漠物?牰敡汣慴琠敯摮?摴敨慥琠桰?慲晣瑥敮牴?捧慥洠牯敦氠楃穄申洹愭扰?捳潩浴扩楶湥攠摣?睬楬瑳栠?掲栠放洠漰琬栠攼物愾灐礼??眾栠椼挠栰?挰愵温?瀠牔潨癥椠摡敧?愠?捦攠牴瑨慥椠湳?牲敶晩敶牡敬渠捧敲?晵潰爠?瑡桳攠?瑯牵敮慧瑥浲攠湴瑨?潮映?慨摡癴愠湯捦攠摴?乥匠????h group. The number of people with moderate/high differentiation degree, T₄N₀M₀/T₄N₁M₀, tumor diameter <3 cm, squamous cell carcinoma/other pathological types was higher than that of the death group. The percentage of CD39-positive cells and the level of CD8⁺ were lower than those of the death group, while the levels of CD3⁺ and CD4⁺ were higher than those of the death group. The difference between the two groups was statistically significant (P < 0.05). The results of multiple linear regression analysis showed that the percentage of CD39-positive cells was negatively correlated with CD3⁺ and CD4⁺ (β < 0, P < 0.05), and positively correlated with CD8⁺ (β > 0, P < 0.05). The results of COX regression analysis showed that there was an independent correlation between the percentage of CD39-positive cells and patient death (HR = 1.812, 95% CI: 1.246- 2.571). The results of subgroup analysis showed that the correlation between the percentage of CD39-positive cells under different infiltrating T cells and patient death remained stable. The results of ROC curve analysis showed that the percentage of CD39-positive cells had a high predictive value for patient death, with a sensitivity of 0.821, a specificity of 0.835, and an AUC value of 0.874. The Kaplan-Meier survival curve of the overall survival rate of patients showed that the 2-year cumulative survival rates of patients with the percentage of CD39-positive cells ≤ 17.89% and the percentage of CD39-positive cells > 17.89% were 75.63% and 66.72%, respectively, and the difference was statistically significant (P < 0.05). Conclusion The CD39 level in patients w

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