外周血可溶性PD-L1在侵袭性B细胞淋巴瘤预后评估中的价值

Peripheral blood soluble PD-L1 as a biomarker for prognosis assessment of patients with malignant B-cell lymphoma

目的探讨外周血可溶性程序性细胞死亡配体1(sPD-L1)和程序性细胞死亡受体1(sPD-1)表达对侵袭性B细胞非霍奇金淋巴瘤(B-NHL)患者预后的评估作用。方法收集109例新诊断B-NHL患者(BNHL组)及52例健康成人(对照组)外周血标本,利用酶联免疫吸附测定(ELISA)法检测血浆中sPD-L1和sPD-1水平。B-NHL组在6周期治疗后再次检测sPD-L1。分析sPD-L1对B-NHL组患者临床特征及无进展生存期(PFS)和总生存期(OS)的影响。结果B-NHL组血浆sPD-L1显著高于对照组[3.79(2.07,6.27)ng/mL vs0.73(0.61,1.62)ng/mL,P<0.001];但sPD-1水平与对照组相比,差异无统计学意义(P=0.105)。sPD-L1升高与大肿块(P=0.022)和低完全缓解率(P=0.041)有关。B-NHL组治疗后sPD-L1水平较治疗前明显下降(P<0.001)。以4.54 ng/mL为截断值,sPD-L1≥4.54 ng/mL患者的OS和PFS均差于sPD-L1<4.54 ng/mL患者(P=0.007和P=0.006)。结论B-NHL外周血sPD-L1高水平与治疗反应差和预后不良相关;外周血sPD-L1可作为B-NHL不良预后的生物学标志。

Objective To investigate the clinicopathological impacts of peripheral blood soluble PD-L1(sPD-L1)and soluble PD-1(sPD-1)in patients with malignant B-cell non-Hodgkin lymphoma(B-NHL).Methods The levels of plasma sPD-L1 and sPD-1 were determined in 109 B-NHL patients and 52 healthy controls using enzyme-linked immunosorbent assay(ELISA).After 6 cycles of treatment,sPD-L1 was measured again in the B-NHL patients.The correlation of sPD-L1 with clinical features,progression-free survival(PFS)and overall survival(OS)in B-NHL was analyzed.Results The sPD-L1 level was significantly higher in B-NHL than that in healthy controls with a median value of 3.79(2.07,6.27)ng/mL vs 0.73(0.61,1.62)ng/mL(P<0.001).There was no significant difference in the level of sPD-1 between B-NHL and healthy controls(P=0.105).The sPD-L1 level in the B-NHL group significantly decreased after treatment compared to before treatment(P<0.001).Taking 4.54 ng/mL as the cut-off value,the overall survival(OS)and progression-free survival(PFS)of patients with sPD-L1≥4.54 ng/mL were worse than those patients with sPD-L1<4.54 ng/mL(P=0.007 and P=0.006,respectively).Conclusion Higher sPD-L1 level is associated with poorer OS and PFS in patients with B-NHL.The plasma sPD-L1 is a valuable biomarker for predicting poor prognosis of malignant B-NHL.