A2aR在弥漫大B细胞淋巴瘤组织和CD8^＋T细胞上的表达和预后价值的研究

Expression and prognostic value of immune checkpoint molecule A2aR in tumor tissue and on the surface of CD8^+T cells in diffuse large B cell lymphoma

目的:探讨A2a R在弥漫大B细胞淋巴瘤(diffuse large B cell lymphoma,DLBCL)组织和CD8^+T细胞上的表达及与患者临床病理特征和预后的相关性。方法:回顾性分析2010年1月1日至2015年12月31日就诊于天津医科大学肿瘤医院初治的72例DLBCL患者临床病理资料。采用多重免疫组织化学法检测组织中A2a R、CD8的表达,采用χ2检验分析其与患者临床病理特征的相关性,应用Kaplan-Meier法进行生存资料分析。结果:DLBCL组织中A2a R总表达阳性率为41.7%(30/72),与患者分期、IPI评分、Ki-67、β2-MG、B症状相关(P<0.05);A2a R^+组患者总生存期(overall survival,OS)较A2a R-组差(P<0.05)。DLBCL组织中CD8^+T细胞上A2a R表达阳性率为22.2%(16/58),与患者分期、IPI评分、Ki-67、β2-MG、乳酸脱氢酶(lactate dehydrogenase,LDH)、结外受累数目、B症状相关(P<0.05);A2a R^+CD8^+组患者OS较A2a R-CD8^+组显著更差(P<0.001)。结论:A2a R总表达及CD8^+T细胞上A2a R表达与DLBCL患者临床病理特征及预后密切相关。检测CD8^+T细胞上A2a R表达可更好地评价DLBCL患者的预后。

Objective： To investigate the expression of adenosine A2 A receptor（A2 a R） in tumor tissue and on the surface of CD8~＋T cells and its correlation with clinicopathologic characteristics and prognosis of patients with diffuse large B cell lymphoma（DLBCL）.Methods： A retrospective analysis was performed on the clinicopathologic characteristics of 72 newly diagnosed patients at Tianjin Medical University Cancer Institute and Hospital from January 2010 to December 2015. The expression of A2 a R and CD8 was evaluated by multiple immunohistochemical staining assays. The associations between the expression of A2 a R in tumor tissue and on the surface of CD8~＋T cells and clinicopathologic characteristics were then assessed using the Chi-square test. The Kaplan-Meier method was used for the analysis of survival. Results： The positive rate of A2 a R total expression in DLBCL was 41.7%（30/72）, which was associated with several clinicopathologic characteristics including stage, International Prognostic Index（IPI） score, Ki-67 index score, β-2 microglobulin（MG）, and B symptoms（P0.05）. Survival analysis showed that patients with positive A2 a R expression had poorer overall survival（OS） than those with negative A2 a R expression（P0.05）. The rate of positive A2 a R expression on the surface of CD8~＋T cells was22.2%（16/58）. The expression of A2 a R on the surface of CD8~＋T cells was correlated with several clinicopathologic characteristics including stage, IPI, Ki-67, β2-MG, lactate dehydrogenase levels（LDH）, extranodal involvement, and B symptoms（P0.05）. Survival analysis showed that patients with A2 a R~＋CD8~＋status had significantly poorer OS than those with A2 a R-CD8~＋status（P0.001）. Conclusions： Positive expression of A2 a R in tumor tissue and on the surface of CD8~＋T cells is significantly correlated with clinicopathologic characteristics and prognosis of patients with DLBCL. The detection of A2 a R on the surface of CD8~＋T cells is superior to evaluate the prognosis of patients with DLBCL.