Effects Of Peripheral Blood Kynurenine And Regulatory T Cells On R-Chop Treatment Of Diffuse Large B-Cell Lymphoma

Objective: Kynurenine(Kyn)and regulatory T cells(Treg)inhibit anti-tumor immune responses,Promote tumor cell survival,growth,distant migration and invasion metastasis,and participate in the body’s immune editing process to support cancer cells to escape the human immune system(1-3).In this study,the expression levels of Kyn and proportion of Treg in peripheral blood of patients with DLBCL were detected,and the relationship between their expression levels and clinicopathological features of DLBCL was analyzed.The effects of peripheral blood Kyn and Treg on R-CHOP treatment of diffuse large B-cell lymphoma were preliminarily explored.Methods: We collected peripheral blood and complete clinical data of 32 patients with DLBCL who had not received any anti-tumor therapy from the beginning of the year between February 2017 and December 2017 in SichuanProvincial Tumor Hospital.All enrolled patients were initially treated,were CD20 positive,and were treated.The number of cycles is ≥ 3 cycles.Detection of Kyn and Tregs expression levels from collected peripheral blood,Firstly,flow cytometry was used to detect the proportion of Treg in peripheral blood collected.Colorimetric method was used to detect the expression level of Kyn in peripheral blood,Preliminary analysis of the expression levels of Kyn and proportion of Treg and the clinicopathological features of DLBCL and the effects of R-CHOP treatment on diffuse large B-cell lymphoma.SPSS22.0software was used for statistical analysis,and the measurement data were sall expressed.The two sets of measurement data are compared with the normal distribution using two independent sample T tests,and the Wilcoxon signed rank sum test is not used for the normal distribution.Before and after treatment,the paired test was used for comparison.The paired T-test was used for the normal distribution,and the relevant sample rank test was used for the normal distribution.The classification and counting data were expressed as frequency or rate.Pearson chi-square test was used for comparison.Fisher’s exact probability method was used when the sample size was less than 40.Results:(1)The mean level of Kyn detected in the peripheral blood of 32 patients with DLBCL who entered the group was 4.89 0.82,which was higher than the mean level of Kyn in the peripheral blood of the healthy adult group(4.43 0.49).The difference was statistically significant(t= 2.459,p=0.018);The average level of Treg detected in the peripheral blood of 32 patients withDLBCL who entered the group was 5.33 2.68,which was higher than the average level of Treg in the peripheral blood of healthy adults(0.58 0.93).The difference was statistically significant(t= 8.955,p < 0.001).(2)The average level of Kyn in peripheral blood after chemotherapy was significantly lower than the average Kyn level in peripheral blood before chemotherapy.Statistically significant(t= 2.090,p=0.041).The average level of Treg in peripheral blood after chemotherapy was significantly lower than the average Treg level in peripheral blood before chemotherapy,Statistically significant(t=2.037,p=0.046).(3)After 4 cycles of chemotherapy,32 patients achieved complete remission(CR)of the 9 people,accounting for 28.13%,partial response(PR)16 people,accounting for 50.00%,ineffective treatment(Stable disease + Disease progression)seven people,accounting for 21.87%.expression After chemotherapy,the expression level in peripheral blood of patients CR Kyn and significantly lower than the level of expression of Treg in peripheral blood of patients ineffective chemotherapy group,Statistically significant(p= 0.005,p=0.001).The expression of Kyn and the proportion of Treg in peripheral blood of patients with PR after chemotherapy was significantly lower than that in patients with no treatment,Statistically significant(p= 0.046,p=0.032);The expression of Kyn and the proportion of Treg in the peripheral blood of CR patients after chemotherapy was compared with the expression level in peripheral blood of PR patients,Statistically significant(p=0.007,p=0.046).(4)There was a correlation between theexpression level of Kyn and the proportion of Treg,P<0.05,and the correlation was significant.(5)The expression levels of Kyn and the proportion of Treg were not correlated with clinical characteristics such as age,clinical stage,Hans type,B symptoms,NCCN-IPI score,LDH,double expression,and Ki-67.Conclusion:(1)The increased expression of Kyn and Treg in the peripheral blood of DLBCL patients has a certain correlation with the efficacy of R-CHOP in the treatment of diffuse large B-cell lymphoma.(2)The lower the expression of Kyn and Treg in the peripheral blood of patients with diffuse large B-cell lymphoma,the better the therapeutic effect of R-CHOP regimen.It can be speculated that Kyn and Tregs can predict the efficacy of R-CHOP treatment in patients with DLBCL.