PD-L1蛋白、F-NLR在复发/难治弥漫大B细胞淋巴瘤患者疗效判断中的意义

Evaluation of PD-L1 expression and fibrinogen-neutrophil/lymphocyte ratio on clinical efficacy of relapsed/refractory diffuse large B-cell lymphoma

目的了解程序性死亡配体(PD-L1)蛋白、纤维蛋白原联合中性粒细胞/淋巴细胞比值(F-NLR)评分对复发/难治弥漫大B细胞淋巴瘤患者(R/R DLBCL)的疗效判断价值。方法采用免疫组化检测40例R/R DLBCL患者病理组织中PD-L1表达,并检测化疗前后血液纤维蛋白原、中性粒细胞、淋巴细胞水平,分析疗效与PD-L1表达、F-NLR关系。结果40例R/R DLBCL患者应用二线解救方案化疗,其中有效18例,无效22例;肿瘤细胞PD-L1阳性分值(TPS)阳性9例(22.5%),综合阳性分数(CPS)阳性17例(42.5%);CPS阳性组化疗有效率低于CPS阴性组(P<0.05);治疗前F-NLR 0分组的有效率明显高于1、2分组(P<0.05);TPS阴性组与CPS阳性组F-NLR 2分者的有效率低于F-NLR 0分者(P<0.05)。结论CPS联合F-NLR可作为R/R DLBCL患者疗效判断的参考指标。

Objective To evaluate the value of programmed death ligand 1(PD-L1)expression and fibrinogen-neutrophil/lymphocyte ratio(F-NLR)on therapeutic efficacy of relapsed/refractory diffuse large B-cell lymphoma(R/R DLBCL).Methods PD-L1 expression was detected by immunohistochemistry in pathological tissues of 40 R/R DLBCL cases.Blood fibrinogen,neutrophil,and lymphocyte levels were determined before and after chemotherapy.The relationship between PD-L1 expression,F-NLR and therapeutic effect was analyzed.Results Forty patients with R/R DLBCL received second-line chemotherapy,of whom 18 were effective and 22 ineffective.Tumor proportion score(TPS)and combined positive score(CPS)were positive in 9(22.5%)and 17(42.5%)cases,respectively.The chemotherapy efficacy was lower in CPS-positive and F-NLR 1-2 groups than in CPS-negative and F-NLR 0 groups(P<0.05),and so did in TPS-negative or CPS-positive plus F-NLR 2 groups compared with F-NLR 0 group(P<0.05).Conclusion CPS plus F-NLR may be helpful in judging the clinical efficacy of R/R DLBCL.