血清TTR、PD-L1与复发或难治弥漫性大B细胞淋巴瘤临床病理特征及预后的关系  

Relationship of Serum TTR and PD-L1 Levels with the Pathological Characteristics and Prognosis of Patients with Relapsed/Refractory Diffuse Large B-cell Lymphoma

作　　者：周航 王玉[1] 彭亚楠 ZHOU Hang;WANG Yu;PENG Yanan(Nanyang Central Hospital,Nanyang,473000)

机构地区：[1]河南省南阳市中心医院,473000

出　　处：《实用癌症杂志》2022年第5期758-762,共5页The Practical Journal of Cancer

基　　金：河南省医学科技攻关计划联合共建项目(编号:LHGJ20190956)。

摘　　要：目的研究血清甲状腺素运载蛋白(TTR)与可溶性程序性死亡配体1(sPD-L1)与复发或难治性弥漫性大B细胞淋巴瘤(R/R DLBCL)临床病理特征及预后的关系。方法将170例初治DLBCL患者纳为研究对象,抽取治疗前外周静脉血,采用R-CHOP方案化疗2~8个周期,评估疗效,将其中41例被评估为R/R DLBCL,纳为R/R DLBCL组,129例为缓解DLBCL,纳为DLBCL组。比较两组治疗前血清TTR及PD-L1水平,并分析R/R DLBCL患者血清TTR与PD-L1水平与其临床病理特征及预后的关系。结果R/R DLBCL组患者血清TTR及sPD-L1水平均显著高于缓解组(P<0.05)。R/R DLBCL患者结外病变、血清LDH与其血清TTR及sPD-L1水平有关(P<0.05),其他临床特征与血清TTR及sPD-L1水平无明显相关性(P>0.05);Hans分型、C-MYC/BCL-2及C-MYC/BCL-2/BCL-6表达水平与R/R DLBCL患者血清TTR及sPD-L1水平相关,其他病理特征与R/R DLBCL患者血清TTR及sPD-L1水平无相关性(P>0.05);以R/R DLBCL患者血清平均TTR及sPD-L1水平为分界点,将41例R/R DLBCL患者分为TTR高表达组(n=20)与低表达组(n=21),sPD-L1高表达组(n=16)与低表达组(n=25),绘制生存曲线发现,TTR高表达组患者生存状况显著优于TTR低表达组(P<0.05)。sPD-L1高表达组患者生存状况显著优于sPD-L1低表达组(P<0.05)。结论初次治疗前血清TTR及sPD-L1水平可有效反映DLBCL患者治疗效果及疾病进展,且在预测R/R DLBCL患者预后中也具有良好的价值。Objective To investigate the relationship of serum transthyretin(TTR)and soluble programmed death-ligand 1(sPD-L1)levels with the pathological characteristics and prognosis of patients with relapsed/refractory diffuse large B-cell lymphoma(R/R DLBCL).Methods 170 patients with treatment-naive DLBCL were enrolled.Baseline peripheral venous blood was collocted.All patients received rituximab in combination with cyclophosphamide,doxorubicin,vincristine,and prednisone chemotherapy(R-CHOP)for 2~8 cycles.The treatment outcomes were evaluated,and patients were classified into R/R DLBCL group(n=41)and DLBCL group(n=129).Serum TTR and PD-L1 levels at baseline were compared between groups.Then the relationship of serum TTR and PD-L1 levels with the pathological characteristics and prognosis of patients with R/R DLBCL was discussed.Results Serum TTR and sPD-L1 levels in R/R DLBCL group were significantly higher than those in DLBCL group(P<0.05).In terms of clinical characteristics,serum levels of TTR and sPD-L1 in R/R DLBCL patients were closely correlated with extranodal involvement and serum lactic dehydrogenase(LDH)levels(P<0.05),while showed no correlation with other clinical characteristics(P>0.05).In terms of pathological characteristics,serum levels of TTR and sPD-L1 in R/R DLBCL patients were closely correlated with Hans classification,C-MYC/BCL-2 and C-MYC/BCL-2/BCL-6 expressions(P<0.05),while no correlation was found in rest pathological characteristics(P>0.05).Taking the average levels of two indicators as the cut-off point,R/R DLBCL patients were divided into TTR high expression group(n=20),TTR low expression group(n=21),sPD-L1 high expression group(n=16)and sPD-L1 low expression group(n=25).The survival curve showed that the survival status of patients with high expression of TTR or sPD-L1 was significantly better than that of patients with low expression of TTR or sPD-L1(all P<0.05).Conclusion Baseline serum levels of TTR and sPD-L1 of DLBCL patients can effectively reflect the clinical outcomes of the initial

关 键 词：血清甲状腺素运载蛋白 可溶性程序性死亡配体1 复发/难治弥漫性大B细胞淋巴瘤 病理特征 预后 

分 类 号：R733.4[医药卫生—肿瘤]