TOP2A和PD-L1在系统性间变性大细胞淋巴瘤中的表达和预后意义

Expression of TOP2A and PD-L1 in systemic anaplastic large cell lymphoma and their prognostic significance

目的:探究人类拓扑异构酶Ⅱα(topoisomerases typeⅡα,TOP2A)和细胞程序性死亡配体1(programmed cell death-ligand 1,PD-L1)在系统性间变性大细胞淋巴瘤(systemic anaplastic large cell lymphoma,sALCL)中的表达及其与临床病理特征之间的关系。方法:应用免疫组织化学法检测2010年3月至2022年6月福建省肿瘤医院诊断的44例sALCL患者TOP2A与PD-L1的表达。采用电话的方式进行随访,随访截至2022年4月15日。结果:44例sALCL患者中,男32例,女12例,年龄12~78(中位51)岁,根据世界卫生组织(World Health Organization,WHO)分型间变性淋巴瘤激酶(anaplastic lymphoma kinase,ALK)阳性患者17例,ALK阴性患者27例。TOP2A蛋白表达的阳性率为60.5%(26/43),PD-L1蛋白表达的阳性率为47.4%(18/38),TOP2A和PD-L1蛋白表达之间存在显著相关性(r=0.560,P=0.001)。本组病例随访时间1~137个月,单因素分析结果显示:TOP2A(P=0.017)、PD-L1(P=0.025)、乳酸脱氢脱酸酶(lactic dehydrogenase,LDH)表达水平(P=0.004)、肝脾肿大(P=0.045)是影响sALCL患者预后的因素。结论:TOP2A和PD-L1的表达在sALCL中呈正相关,且TOP2A蛋白阴性和PD-L1蛋白阴性患者预后较阳性患者好,可作为预测sALCL预后的重要指标。

Objective: To reveal the expression and clinicopathological significance of topoisomerases type Ⅱα(TOP2A) and programmed cell death-ligand 1(PD-L1) in systemic anaplastic large cell lymphoma(sALCL). Methods: Forty-four patients with sALCL diagnosed from March 2010 to June 2022 at Fujian Cancer Hospital were selected for the detection of TOP2A and PD-L1 by immunohistochemistry. Follow-up using telephone interview was conducted to detect the survival of patients up to April 15, 2022. Results: Of the 44 sALCL patients, 32 were males, 12 were females, with a median age 51 years(ranging from 12 to 78 years). All 44 cases were divided into 2 types according to the World Health Organization(WHO) classification, namely, anaplastic lymphoma kinase(ALK) positive ALAL(n=17) and ALK negative ALCL(n=27). The positive rates of TOP2A and PD-L1 were 60.5%(26/43) and 47.4%(18/38), respectively. According to the result of Spearman correlation analysis, the expression of TOP2A protein was associated with that of PD-L1 protein in sALCL. In addition, the follow-up time ranged from 1 to 137 months. As reveal by Kaplan-Meier survival analysis, the prognosis of patients was related to TOP2A(P=0.017), PD-L1(P=0.025), lactic dehydrogenase(LDH)(P=0.004) and hepatosplenomegaly(P=0.045). Conclusion: The expression of TOP2A protein is associated with that of PD-L1 in sALCL, and that the negative expression of TOP2A and PD-L1 protein is better than that of patients with positive expression, which can be served as an effective prognostic biomarker of sALCL.