Expression Of CD47 In Classic Hodgkin’s Lymphoma And Its Clinical Significance

Objective:To study the expression of immune checkpoint molecule CD47 in classic Hodgkin’s lymphoma and its clinical significance.Methods:Ninety samples of patients with classic Hodgkin lymphoma from Cancer Hospital of Chinese Academy of Medical Sciences were collected,54 cases of Nodular sclerosis classic Hodgkin lymphoma,28 cases of Mixed-cellularity classic Hodgkin lymphoma,6 cases of Lymphocyte-rich classic Hodgkin lymphoma and 2 cases of Lymphocyte depletion classic Hodgkin lymphoma.The immunohistochemical staining was used to compare the high and low expression of CD47 and to analyze the significance of the immune microenvironment and clinicopathological features of classic Hodgkin lymphoma.The expression and clinical significance of PD-1,PD-L1,and EBV-LMP1 in classic Hodgkin’s lymphoma were also explored in this subject.Results:This study showed that among 90 cases of classic Hodgkin’s lymphoma,there were 22 cases with high CD47 expression and 68 cases with low CD47 expression.Factors associated with high CD47 expression included:male(P=0.044),age≥45 years(P=0.000),PD-L1 positive(P=0.024),and factors associated with positive PD-L1 expression:age≥45 years(P=0.033),Ann Arbor stage(Ⅲ/Ⅳ)(P=0.002).In the K-M survival analysis,risk factors associated with OS were found to be:high CD47 expression(P=0.024),age≥45 years(P=0.031),consistent with the results in the univariate analysis.In the univariate analysis of event-free survival EFS,the risk factors were:high CD47 expression(p=0.020),high CD47 expression/PD-L1 co-expression(p=0.001),and B symptoms(p=0.047).In the event-free survival(EFS)multifactorial analysis,B symptoms were found to be an independent risk factor for event-free survival in patients.Conclusion:In this study,we analyzed the expression of CD47 in classic Hodgkin’s lymphoma and its correlation with the immune microenvironment,clinicopathological features,and prognosis of classic Hodgkin lymphoma,and found that the CD47 high expression group had a poorer prognosis in the survival analysis.The results provide further evidence to support clinical trials of CD47-targeted agents.B symptoms are an independent risk factor for event-free survival of patients,which provides a new direction for clinicians to determine the prognosis of patients.