Expression And Significance Of CD47, PD1 And PDL1 In T-cell Acute Lymphoblastic Lymphoma/Leukemia

Objective:T-lymphoblastoma lymphoma/leukemia(T-LBL/ALL),because of its high degree of malignancy,poor prognosis,and chemotherapy resistance after routine treatment,has made it urgent to find new targets for the treatment of diseases.This article investigates the expression of CD47,PD1,and PDL1 in T-lymphoblastoma/leukemia(T-LBL/ALL)and its correlation with the clinicopathological features and prognosis of T-LBL/ALL patients,providing new directions for treatment.Methods:Firstly,56 samples of T-LBL/ALL paraffin-embedded specimens collected from Department of Pathology,Shanxi Cancer Hospital from 2013 to 2016 were served as the experimental group,and 20 cases of lymph node reactive hyperplasia(LH)were collected as control group.Secondly,tissue waxes of the experimental group and the control group were made into tissue pellets,and we detected the expression of CD47,PD1,and PDL1 protein by the EnVision method of immunohistochemistry in the experimental group and the control group.Thirdly,the qRT-PCR method was used to detect the mRNA relative expression of CD47,PD1 and PDL1.Furthermore,we used SPSS17.0 statistical software to analyze the expression of CD47,PD1 and PDL1 in patients with T-LBL/ALL,and their correlations with clinicopathologic factors and prognosis.Lastly to draw prognostic chart by GraphPad Prism 5 software.Results:1.Immunohistochemical results: The high expression rate of CD47 in the experimental group was 46.4%(26/56),which was higher than that of the control group 15%(3/20),and the difference was statistically significant(P=0.027).PD1 protein was not expressed in T-LBL/ALL tumor cells but in tumor infiltrating immune cells,and the positive rates of PD1 protein was 17.9%(10/56)in the experimental group,which was statistically significant compared with control group(18/20,90%)(P=0.000).The positive rates of PDL1 protein were 37.5%(21/56)in the experimental group,and 10%(2/20)in the the control group,accordingly the difference between the two groups was statistically significant(P= 0.044).2.Results of qRT-PCR: The relative expression levels of CD47,PD1 and PDL1 mRNA in 56 cases of T-LBL/ALL were significantly higher than those in control group(6.915 vs 4.050;12.255 vs 2.575;37.990 vs 3.615,respectively),and the differences were statistically significant(P all <0.05).3.Univariate analysis showed that age,hepatomegaly,CD47 protein and m RNA and PDL1 protein and mRNA expression were closely correlated with overall survival(OS)(P all <0.05),and the high expression of CD47 protein and PDL1 protein was associated with PFS.Multivariate Cox regression analysis showed that the high expression of CD47 protein and PDL1 protein was independent prognostic factors of T-LBL/ALL(P all <0.05).Conclusion:In T-LBL/ALL,PD1/PDL1 may be involved in the immune escape of T-LBL/ALL and is expected to become a new target for the treatment of disease.The high expression of CD47 is an independent prognostic risk factor for T-LBL/ALL and may be involved in the progression and prognosis of the disease.The detection and localization of CD47,PD1 and PDL1 may provide a reasonable basis for T-LBL/ALL targeted therapy strategy.