PD-L1、PD-L2、CD30、CD23和BCL-6在原发纵隔大B细胞淋巴瘤诊断和预后评估中的应用价值  

Application of PD-L1,PD-L2,CD30,CD23 and BCL-6 in Diagnosis and Prognostic Evaluation of Primary Mediastinal Large B-cell Lymphoma

作　　者：袁婷 曹铮 刘秀云 郑波 冯晓莉 YUAN Ting;CAO Zheng;LIU Xiuyun;ZHENG Bo;FENG Xiaoli(Department of Pathology,National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100021,China)

机构地区：[1]国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院病理科,北京100021

出　　处：《肿瘤防治研究》2021年第10期941-946,共6页Cancer Research on Prevention and Treatment

摘　　要：目的探讨治疗相关标志物PD-L1、PD-L2、CD30、CD23、BCL-2、BCL-6、MUM1和GATA3在原发纵隔大B细胞淋巴瘤(PMBL)诊断和预后评估中的应用价值。方法收集PMBL的34例患者进行回顾性研究,31例非纵隔原发的非特指型弥漫性大B细胞淋巴瘤(DLBCL-NOS)作为对照组,免疫组织化学染色方法检测8种蛋白的表达情况。结果PD-L1、PD-L2和CD30在PMBL组阳性肿瘤细胞百分比的中位数分别为70%(30%,90%)、25%(0,70%)和17.5%(0,60%),显著高于DLBCL-NOS组,差异有统计学意义(P<0.05);CD30和CD23在PMBL组的阳性率分别为61.76%(21/34)和76.47%(26/34),与DLBCL-NOS组之间差异有统计学意义(P=0.000)。伴有CD30或BCL-6表达的PMBL患者生存曲线尽管P>0.05,仍显示出预后差的趋势。结论PMBL中PD-L1、PD-L2和CD30的表达水平较高,有助于精准识别更多可能对免疫或靶向治疗有反应的患者。免疫组织化学标记PD-L1、PD-L2、CD30和CD23有助于PMBL与DLBCL-NOS鉴别诊断。CD30和BCL-6作为PMBL的候选预后指标应该在更大量的样本中进一步研究。Objective To explore the application value of treatment-related markers PD-L1,PD-L2,CD30,CD23,BCL-2,BCL-6,MUM1 and GATA3 in the diagnosis and prognostic evaluation of primary mediastinal B-cell lymphoma(PMBL).Methods A retrospective study was conducted on 34 patients diagnosed with PMBL,and 31 patients with DLBCL-NOS which was not primary in the mediastinum were taken as control group.The expressions of 8 proteins were detected by IHC staining.Results The median percentages of tumor cells with PD-L1,PD-L2 and CD30 expression in PMBL group were 70%(30%,90%),25%(0,70%)and 17.5%(0,60%)respectively,which were significantly higher than those in the DLBCL-NOS group(P<0.05).The positive rates of CD30 and CD23 in PMBL group were 61.76%(21/34)and 76.47%(26/34)respectively,significantly different with those in the DLBCL-NOS group(P=0.000).The survival curve of PMBL patients with CD30 or BCL-6 expression showed a trend of poor prognosis,despite the P value was>0.05.Conclusion The high expression levels of PD-L1,PD-L2 and CD30 in PMBL are helpful to accurately identify more patients who may respond to immune or targeted therapy.Immunohistochemical staining of PD-L1,PD-L2,CD30 and CD23 is helpful for the differential diagnosis of PMBL and DLBCL-NOS.As candidate prognostic indicators of PMBL,CD30 and BCL-6 should be further studied in a larger number of samples.

关 键 词：淋巴瘤 纵隔 免疫组织化学 PD-L1 PD-L2 CD30 CD23 BCL-6 

分 类 号：R733[医药卫生—肿瘤]