PD-L1和PD-1在外周T细胞淋巴瘤中的表达及临床意义

The expressions and clinical significance of PD-L1 and PD-1 in peripheral T-cell lymphoma

目的探讨程序性死亡1-配体（PD-L1）和程序性死亡因子-1（PD-1）在外周T细胞淋巴瘤（PTCL）组织中的表达及临床意义。方法采用免疫组织化学法检测51例PTCL组织（PTCL组）及20例淋巴结良性增生病变组织（对照组）中PD-L1和PD-1的表达情况,分析其表达与患者临床病理特征及预后之间的关系。结果 PTCL组PD-L1的阳性表达率高于对照组（74.51%vs 35.00%,χ^2=9.662,P〈0.05）,PD-1的阳性表达率高于对照组（66.67%vs25.00%,χ^2=10.074,P〈0.05）。PD-L1和PD-1的阳性表达率均仅在外周血不同乳酸脱氢酶（LDH）水平PTCL患者间差异有统计学意义（P〈0.05）。PTCL患者经2个疗程CHOP或EPOCH方案化疗后,PD-L1阴性表达组化疗有效率（RR）优于阳性表达组（84.6%vs 47.4%,χ^2=5.478,P〈0.05）,PD-1阴性表达组RR优于阳性表达组（82.4%vs44.1%,χ^2=6.755,P〈0.05）。PD-L1阴性表达组的中位总生存期（OS）高于阳性表达组（29.8个月vs 17.6个月,χ^2=4.413,P〈0.05）;PD-1阴性表达组的中位OS高于阳性表达组（29.8个月vs 17.6个月,χ2=8.293,P〈0.05）。结论PD-L1和PD-1在PTCL组织中均表达增高,且与患者外周血高LDH水平及化疗疗效差、生存期短有关,是判断PTCL化疗疗效欠佳及预后不良的因子。

Objective To investigate the expression levels and clinical significance of programmed cell death 1 ligand（PD-L1） and programmed cell death factor-1（PD-1） in peripheral T-cell lymphoma（PTCL）. Methods Immunohistochem-istry was used to detect expression levels of PD-L1 and PD-1 in PTCL（test group, n=51） and benign proliferative lesions oflymph node tissues（control group, n=20）. The correlations of PD-L1 and PD-1 expressions with clinical pathological param-eters and prognosis were analyzed between two groups. Results The expression level of PD-L1 was significantly higher inPTCL group than that in control group（74.51% vs 35.00%, χ~2=9.662, P〈0.05）. The positive expression of PD-1 was signifi-cantly higher in PTCL group than that in control group（66.67% vs 25.00%, χ~2=10.074, P〈0.05）. There were significant dif-ferences in PD-L1 and PD-1 expressions between different peripheral lactate dehydrogenase（LDH） levels of PTCL group（P〈0.05）. After two cycles of CHOP or ECHOP treatments, the response rate（RR） was higher in PD-L1 negative group thanthat in positive group（84.6% vs 47.4%,χ~2=5.478, P〈0.05）, and RR was higher in PD-1 negative group than that in positivegroup（82.4% vs 44.1%, χ~2=6.755, P〈0.05）. The median overall survival（OS） time was higher in PD-L1 negative group thanthat in positive group（29.8 months vs 17.6 months,χ~2=4.413, P〈0.05） and the median OS time was higher in PD-1 negativegroup than that in positive group（29.8 months vs 17.6 months, χ~2=8.293, P〈0.05）. Conclusion There are high expressionlevels of PD-L1 and PD-1 in peripheral T-cell lymphoma, which is closely related with the elevated LDH in peripheralblood, poor response rate and shorter OS. Therefore, the expression levels of PD-L1 and PD-1 can be used as factors ofworse effect of chemotherapy and poor prognosis.