MYC/BCL2双表达大B细胞淋巴瘤中PD-L1的表达及其临床意义

王平; 杨文秀; 周杰; 冯江龙; 林超群

doi:10.3971/j.issn.1000-8578.2020.19.0957

MYC/BCL2双表达大B细胞淋巴瘤中PD-L1的表达及其临床意义

Expression of PD-L1 and Its Clinical Significance in MYC/BCL2 Double-expression Large B Cell Lymphoma

摘要

摘要:
目的探讨MYC/BCL2双表达大B细胞淋巴瘤(DEL)与程序性细胞死亡受体-配体1 (PD-L1) mRNA、蛋白表达的相关性及其临床意义。
方法收集90例弥漫大B细胞淋巴瘤(DLBCL)病例, 采用免疫组织化学染色检测MYC、BCL2蛋白并分组, 双标记染色法检测各组病例的肿瘤细胞或微环境细胞中PD-L1表达; 实时荧光PCR技术(Real-time PCR, qPCR)检测DEL组与non-DEL组PD-L1 mRNA相对表达量; 收集临床病理资料并随访, 对实验数据进行统计学分析。
结果 90例样本中28例为DEL, 肿瘤细胞和微环境中PD-L1⁺分别为22例和26例。DEL组肿瘤细胞和微环境中PD-L1⁺分别为14例和9例; 肿瘤细胞和微环境细胞PD-L1蛋白表达与DEL存在相关性(P < 0.05); PD-L1 mRNA相对表达量在DEL与non-DEL组间存在显著差异(P=0.012); DEL组中PD-L1⁺与IPI评分和B症状的出现有关(P=0.007、0.021); Kaplan-Meier显示DEL中PD-L1⁺、肿瘤微环境PD-L1阳性(mPD-L1⁺)与患者预后相关(P=0.005、0.001)。
结论 DEL患者PD-L1 mRNA及蛋白表达都明显上调且与患者不良预后相关, PD-L1可作为DEL患者不良预后评估的危险因素。

Abstract:
Objective To investigate the correlation between MYC/BCL2 double-expression large B cell lymphoma (DEL) and programmed cell death ligand 1 (PD-L1) mRNA or protein expressions and analyze the clinical significance of PD-L1 protein expression in DEL.
Methods We collected 90 cases of diffuse large B-cell lymphoma(DLBCL) and detected MYC and BCL2 protein by immunohistochemical staining, and then grouped them into DEL and non-DEL groups. The expressions of PD-L1 in tumor cells or microenvironment were detected by immunohistochemical double labeling staining. qPCR was used to detect the relative expression of PD-L1 mRNA. The clinicopathological data were collected and followed up.
Results Among 90 cases of DLBCL, there were 28 cases of DEL, 22 cases of PD-L1 expression in tumor cells (PD-L1⁺) and 26 cases in microenvironment (mPD-L1⁺); while, 14 cases of PD-L1 expression in tumor cells and 9 cases in microenvironment in DEL group. PD-L1 protein expression in tumor cells or microenvironment was correlated with DEL (P < 0.05). The relative expression of PD-L1 mRNA was significantly different between two groups (P=0.012). PD-L1⁺ was related to IPI score and B symptom in DEL group (P=0.007, 0.021). PD-L1⁺ and mPD-L1⁺ were correlated with the prognosis of patients in DEL group (P=0.005, 0.001).
Conclusion The mRNA and protein expression of PD-L1 are significantly up-regulated in DEL patients and correlated with the prognosis. PD-L1 could be used as an independent risk factor for the evaluation of poor prognosis of DEL patients.

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