The Expression Of PD-1 And PD-L1 In EBV-related Non-Hodgkin’s Lymphoma And Its Influence On Prognosis

Background Non-Hodgkin’s lymphoma(NHL)is the most common type of lymphoma,accounting for about 90%of all lymphomas.In recent years,the burden of NHL in China and even the world continues to increase;After standard treatment,about 50%of patients can achieve long-term survival,but some patients still show poor prognosis due to recurrence or refractory treatment.Therefore,it is urgent to seek more effective therapeutic targets and strategies for these patients.EBV is the first confirmed oncogenic virus,which can infect B,T cells and epithelial cells,leading to a variety of lymphohematopoietic diseases and epithelial tumors.EBV infection is believed to be associated with the poor prognosis of some lymphomas and participate in the occurrence and development of some NHL,but the prognosis of EBV-related NHL needs to be further analyzed and studied.Therefore,it is necessary to analyze the impact of EBV infection on patient prognosis,so as to explore more effective treatment strategies and protocols.Therefore,we focus on the PD-1/PD-L1 immune checkpoint,which is a hot research topic in recent years.PD-1/PD-L1 inhibitors have shown significant efficacy and great development potential in the treatment of a variety of malignant tumors.In lymphoma,PD-1/PD-L1 inhibitors are less commonly used.Nivolumab,a PD-1 inhibitor,is currently approved for the treatment of CHL that has progressed or relapsed after hematopoietic stem cell transplantation and CD30 monoclonal antibody therapy.Currently,PD-L1 inhibitors have not been approved for the treatment of lymphoma in China.The therapeutic effect of PD-1/PD-L1 inhibitors in lymphoma needs to be further studied.Purpose By detecting EBV infection and the expression of PD-1/PD-L1 in 200 NHL patients and their corresponding prognostic effects,this study analyzed the correlation and prognostic effects of the two,and expounded the application of PD-1/PD-L1 inhibitors in lymphoma.To explore the expression of PD-1/PD-L1 and the application of its inhibitors in NHL patients with positive EBV,so as to explore a new direction of targeted drug therapy based on the conventional treatment of such patients.Methods In situ hybridization was used to detect the expression of EBER;immunohistochemistry was used to detect the expression of PD-1/PD-L1;the chi-square test was used to compare categorical variables,the Spearman test was used for correlation,and the single factor Kaplan-Meier method and Log-rank test were used for survival analysis.Results The infection of EBV was different in different types of NHL,and the infection rate of T/NK cell type was higher.NHL patients with positive EBV have a poor prognosis,and patients with HPS have a worse prognosis.Dynamic monitoring of peripheral blood EBV-DNA quantification has important prognostic significance.The expression of PD-1/PD-L1 is different in different types of NHL.In NHL,the positive rate of PD-1 was 43.5%,and the positive rate of B-NHL was higher.The positive rate of PD-L1 was 64.5%,and the positive rate of T/NK-NHL was higher.The expression of PD-1 was positively correlated with PD-L1.PD-1 expression did not affect the survival prognosis of patients.PD-L1 positive patients have poor prognosis;The expression of PD-L1 is positively correlated with EBV infection,and the positive rate of PD-L1 is higher in EBV-positive NHL patients,and the prognosis of patients is poor.The application of PD-1 inhibitors is effective not only in the treatment of relapsed/refractory HL cases,but also in some relapsed/refractory NHL patients,especially in some EBV-positive NHL patients with worse prognosis.Due to the small number of cases,further analysis needs to be made by enlarging the sample size.Conclusion The infection of EBV was different in different types of NHL,and the infection rate of T/NK cell type was higher.NHL patients with positive EBV have a poor prognosis,and NHL patients with HPS have a worse prognosis.The expression of PD-1 and PD-L1 was positively correlated.The positive rate of PD-1 in B-NHL is high,and the expression of PD-1 does not affect the survival prognosis of patients.The positive rate of PD-L1 in T/NK-NHL is high,and the prognosis of patients is poor.The positive rate of PD-L1 in EBV-positive NHL patients is high,and the two are positively correlated,and the prognosis of patients is poor.PD-1 inhibitors are effective not only in the treatment of partially relapsed/refractory HL patients,but also in the treatment of partially relapsed/refractory NHL patients,especially in some EBV-positive NHL patients with worse prognosis,which is expected to become a new immunotargeted therapy for EBV-positive NHL patients.