The Expression And Impact Of P53?PD1 And PDL1 In Diffuse Large B-cell Lymphoma

Objective : At present,the prognosis of DLBCL patients is mainly evaluated by IPI clinically,and molecular biology markers have not been included.This study aims to detect the expression of P53,PD1,and PDL1 in DLBCL by immunohistochemistry and analyze their impact on the prognosis of DLBCL patients,and contribute to the establishment of a more accurate prediction model for DLBCL.Method: We collected the clinical data and tissue specimens of 176 patients diagnosed with DLBCL during our hospital from April 2011 to October 2014.The diagnosis is based on the WHO 2008 version of the diagnostic criteria for non-Hodgkin lymphoma.The selected specimens were made into tissue sections and the expression of P53,PD1,and PDL1 proteins in 176 DLBCL tissues was detected by a two-step immunohistochemical detection system(PV-9000).Follow-up was performed on 176 patients with DLBCL.SPSS 22.0 statistical software was used for correlation analysis and survival analysis to draw survival curves.P values <0.05 are considered statistically significant.Result: 1.The P53,PD1 and PDL1 proteins can all be expressed in DLBCL tissues with positive expression rates of 44.9%(79/176),55.1%(97/176),and 42.0%(74/176),respectively.2.The positive expression of P53 may be mostly from non GCB subtype(P=0.06);the positive expression of PD1 is significantly correlated with extranodal involvement number ?1(P=0.008),and the positive expression of PD1 may be related to 1-2 scores of IPI score(P=0.061);There was no significant correlation between PDL1 positive expression and clinicopathological parameters.3.P53 expression was correlated with PD1 expression(R=0.217,P=0.004).P53 expression was correlated with PDL1 expression(R=0.273,P=0.000).4.The 3-year OS and 3-year PFS in the P53 positive expression group were significantly lower than those in the negative expression group(P=0.000,P=0.000).The 3-year OS and 3-year PFS in the PD1 positive expression group were significantly lower than those in the negative expression group(P=0.006,P=0.010).The 3-year OS and 3-year PFS in the PDL1-positive expression group were significantly lower than those in the negative expression group(P=0.020,P=0.000).5.The 3-year OS and 3-year PFS of the P53+/PD1+ co-expression group in DLBCL were significantly lower than those in the P53-/PD1-group(P=0.000,P=0.000).The 3-year OS and 3-year PFS of the P53+/PDL1+ co-expression group were significantly lower than that of the P53-/PDL1-group(P=0.000,P=0.000).6.Multivariate cox analysis showed that age>60 years old(P=0.002),?2 microglobulin levels higher than normal(P=0.006),IPI score 3-5 points(P=0.012),short-term efficacy did not reach remission(P=0.000),positive expression of P53(P=0.000),and positive expression of PD1(P=0.023)were independent prognostic factors negatively impacting OS in DLBCL patients.Age >60 years(P=0.018),?2 microglobulin levels higher than normal(P=0.036),CHOP/CHOPE treatment regimen without rituximab(P=0.011),and short-term efficacy did not reach remission(P=0.000),positive expression of P53(P=0.000),positive expression of PD1(P=0.040)and positive expression of PDL1(P=0.019)were independent prognostic factors negatively impacting PFS in DLBCL patients.Conclusion: 1.P53,PD1 and PDL1 proteins were expressed in DLBCL tissues.2.P53 expression was positive correlated with PD1 and PDL1 expression in DLBCL.3.The prognosis of P53,PD1 or PDL1 protein positive expression group was significantly lower than that of negative expression group in DLBCL.Co-expression of P53+/PD1+ and co-expression of P53+/PDL1+ suggest a worse prognosis.4.The expression of P53,PD1 and PDL1 were the independent prognostic factors negatively impacting survival for DLBCL patients.