Expression Of PD-L1 And Blimp-1 In DLBCL And Its Significance In Prognosis

Objective:The expression of PD-L1 in non-GCB DLBCL and Blimp-1 in DLBCL was detected,and the relationship between the two was analyzed further with clinical features and prognosis,which provided a theoretical basis for the prognosis and targeted treatment of DLBCL.Methods:1 To collect 132 patients of DLBCL(87 non-GCB DLBCL)who were treated during the period of 2011-1 to 2017-10 in the fourth hospital of Hebei Medical University as the research object.The clinical data were complete,and the whole group of patients was detected for Blimp-1 expression by immunohistochemistry,and PD-L1 expression was detected in non-GCB DLBCL patients.2 Using SPSS21.0 software to analyze the expression of PD-L1 and Blimp-1 in patients with clinical characteristics,prognosis and the correlation between the expression of both.The test criteria was defined as statistically significant at P<0.05.Results:1.Immunohistochemistry: The positive expression of PD-L1 in non-GCB DLBCL patients was 77.01%(67/87).The positive expression of Blimp-1 in DLBCL patients was 24.24%(32/132).In non-GCB DLBCL,19.54%(17/87)of PD-L1 and Blimp-1 were positively expressed,11.49%(10/87)of PD-L1 and Blimp-1 were not expressed,PD-L1 was positive and Blimp-1 was negative expression was 57.47%(50/87),PD-L1 negative and Blimp-1positive expression was 11.49%(10/87).2.The relationship between PD-L1 and Blimp-1 expression and clinical characteristics: There was no significant correlation between both of theirexpressions with patient’s gender,age,IPI score,ECOG score,clinical stage,bone marrow involvement,extranodal involvement,B symptoms,LDH,large masses,primary sites,and levels of β-2MG and Ki-67(P>0.05).3.Prognostic analysis: Patients with positive expression of PD-L1 had poorer PFS and 3 years and 5 years OS(P<0.05).Patients with loss expression of Blimp-1 were significantly worse at 3 years and 5 years,but there was no statistically significant difference(P>0.05).There was a negative correlation between the expression of PD-L1 and Blimp-1(r=-0.224,P=0.037).The prognosis of PD-L1+Blimp-1-group was worse than that of the other three groups,and there was a significant difference in 3-year OS(P=0.049).4.Effect of treatment plan on prognosis: Among 132 patients with DLBCL,R+CHOP/CHOPE group had better OS than CHOP/CHOPE group(P=0.045);in 67 cases of PD-L1 positive non-GCB DLBCL,the R+CHOP/CHOPE group had better OS than the CHOP/CHOPE group(P=0.007).Conclusions:1.PD-L1 was highly expressed in non-GCB DLBCL.The positive expression of PD-L1 was associated with poor prognosis of patients.2.The Blimp-1 expression rate is higher in non-GCB type than GCB type in DLBCL.The loss of Blimp-1 expression in non-GCB DLBCL patients indicates a poor prognosis.3.There was a significant negative correlation between PD-L1 and Blimp-1 expression in non-GCB DLBCL.4.Rituximab is effective for treating PD-L1 positive patients.