| Purpose: The expressions of BCL-2,PD-1 and PD-L 1 in DLBCL tissues were detected by immunohistochemical method and their relationship was analyzed.To analyze its effect on the efficacy and prognosis of chemotherapy in DLBCL patients,and to analyze the prognosis.Methods: From May 2011 to March 2014,the clinical data and tissue specimens from 82 patients with DLBCL diagnosed were collected in Chenzhou affiliated hospital of University of South China.The diagnosis was based on the 2016 WHO diagnostic criteria for non-Hodgkin’s lymphoma.The expressions of BCL-2,PD-1 and PD-L1 in 82 DLBCL tissues were detected by immunohistochemistry.The clinicopathological data including sex,tumor location,age,T stage,N stage,IPI score,pathological classification and follow-up data were collected.At the same time,SPSS.22.0 statistical software was used for statistical analysis.Chisquare test was used to compare the counting data.Speraman correlation analysis was used to describe the correlation between the expressions of BCL-2,PD-1 and PD-L1.The expression and survival cycle of BCL-2,PD-1 and PD-L 1 were analyzed by Kaplan-Meier method,and survival curve was drawn.Kaplan-Meier method was used to analyze the clinical factors.Cox proportional hazard model was used for multifactor analysis.P < 0.05 denotes the difference was statistically significant.Results: 1.In DLBCL patients,the positive rates of BCL-2,PD-1 and PD-L 1 were 53%(44/82),32.9%(27/82)and 56%(46/82),respectively.There was a significant correlation between BCL-2 expression and PDL1 expression(R = 0.306,P = 0.005).There was no significant correlation between BCL-2 expression and PD-1 expression(R = 0.183,P = 0.100).2.In DLBCL patients,the positive expression of BCL-2 was significantly correlated with IPI score(P=0.002),pathological type(P=0.019)and B symptoms(P=0.02).However,the expression of BCL-2 was not correlated with the location,age,sex and tumor stage of the patients.3.The expression of PD-1 in DLBCL was significantly correlated with IPI score(P=0.044).However,the expression of PD-1 was not related to the location,age,sex,pathological type,B symptoms and tumor stage of the patients.4.In DLBCL patients,the expression of PD-L1 was significantly correlated with IPI score(P<0.01),B symptoms(P<0.01),age(P=0.044),clinical stage(P=0.014)and pathological type(P=0.007).However,the expression of PD-L1 was not related to the location and sex of the patients.5.The 3-year OS rate and 3-year PFS rate in BCL-2 positive group were significantly different from those in negative group(P=0.046,P=0.006).The 3-year OS rate and 3-year PFS rate in the PD-L1 positive group were significantly different from those in the negative expression group(P < 0.001,P < 0.001).There was no difference in OS rate and PFS rate in 3 years between PD-1 positive group and negative expression group(P=0.811,P=0.365).6.The single factor analysis result showed that the lesions were located outside lymph nodes(P=0.046),clinical stages were stages III-IV(P<0.001),IPI scores were 3-4(P<0.001),symptoms B(P<0.001),positive expression of PD-L1 protein(P<0.001)and positive expression of BCL-2 protein(P=0.033).It had significantly statistical significance in OS of DLBCL patients.The single factor analysis result showed that the lesions were located outside lymph nodes(P=0.031),clinical stages were stages III-IV(P=0.011),IPI scores were 3-4(P<0.001),symptoms B(P<0.001),positive expression of PD-L1 protein(P<0.001)and positive expression of BCL-2 protein(P=0.014).It had significantly statistical significance in OS of DLBCL patients.COX multivariate analysis showed that IPI scores were 3-4(P=0.007),symptoms B(P<0.001).It had significantly statistical significance in OS of DLBCL patients.IPI score were 3-4(P=0.004),B symptoms(P<0.001),and positive expression of PD-L1 protein(P=0.03).It had significant statistical significance in PFS of DLBCL patients.The positive rates of BCL-2,PD-1 and PD-L 1 in DLBCL patients were 53%(44/82),32.9%(27/82)and 56%(46/82),respectively.There was a significant correlation between BCL-2 expression and PD-L1 expression(R = 0.306,P = 0.005).There was no significant correlation between BCL-2 expression and PD-1 expression(R = 0.183,P = 0.100).Conclusions: 1.The expression of BCL-2 was positively correlated with PD-L1 in DLBCL patients,but not with PD-1.2.Intra-nodal location,clinical stage III-IV,IPI score 3-4,B symptoms,positive PD-L1 and BCL-2 protein were independent adverse prognostic factors of 3-year OS in DLBCL patients.Its IPI score was 3-4,B symptoms and positive PD-L1 protein were independent adverse prognostic factors of 3-year PFS in DLBCL patients.3.Positive BCL-2 or PD-L1 protein was an independent adverse prognostic factor for DLBCL patients. |
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