| Background Diffuse large B-cell lymphoma(DLBCL)is one of the most common non-Hodgkin's lymphoma,accounting for about 30%-40% of non-Hodgkin's lymphoma,is a very invasive clinical process,morphological heterogeneity of the tumor.With the advent and popularization of anti-CD20 antibody drugs(rituximab)and the comprehensive use of hematopoietic stem cell transplantation,the survival time of patients with diffuse large B-cell lymphoma has been significantly prolonged.However,about 30% of patients with diffuse large B-cell lymphoma still die because of recurrence or refractory disease.Therefore,it is particularly important to further explore the pathogenesis of diffuse large B-cell lymphoma and evaluate the high-risk factors of diffuse large B-cell lymphoma before treatment.At present,the international prognostic index(international prognostic index,IPI),as a reference index for the prognosis of diffuse large B-cell lymphoma,has been widely recognized,but it still has some limitations.The effect of tumor microenvironment on the pathogenesis and prognosis of diffuse large B-cell lymphoma was not taken into account.Myeloid inhibitory cells(myeloid-derived suppressor cells,MDSCs are a group of cell subsets with negative immunomodulatory function,which play an important role in promoting tumorigenesis and development.MDSCs is highly expressed in multiple myeloma,non-small cell lung cancer and other tumors,and is closely related to the progression of the disease.However,there are few reports on MDSCs in diffuse large B-cell lymphoma.The purpose of this study was to investigate the expression of MDSCs in diffuse large B-cell lymphoma and its prognostic value.Objective In this study,patients with newly diagnosed diffuse large B-cell lymphoma were selected as the object of study.Firstly,we detected the expression of MDSCs in peripheral blood of patients with diffuse large B-cell lymphoma and normal controls.It was combined with clinical data such as age,sex,clinical stage,grouping,LDH,IPI score and total survival time(OS)of diffuse large B-cell lymphoma.To investigate the feasibility and clinical value of MDSCs as a new prognostic indicator in patients with diffuse large B-cell lymphoma.Method From July 2012 to January 2018,52 patients with diffuse large B-cell lymphoma(experimental group),aged(60.8 ±12.4)years,were selected from 901 Hospital of PLA(34 males and 18 females).All cases were confirmed by pathology.at the same time,the clinical data of age,sex,clinical stage,grouping,LDH,IPI score and total survival time(OS)were collected,in which the clinical stage and IPI score were according to the NCCN guidelines in 2014.The control group(Healthy control,HC group)consisted of30 volunteers,18 males and 12 females,aged(57.5 ±7.6)years.There was no significant difference in sex and age between the two groups,and there were no infectious diseases,autoimmune diseases and so on.All the subjects signed a written informed consent,and the research plan was approved by the ethics committee of our hospital.Result.1.MDSCs was expressed in peripheral blood of newly diagnosed patients with diffuse large B-cell lymphoma and control group.The expression of MDSCs in peripheral blood of newly diagnosed patients with diffuse large B-cell lymphoma was significantly higher than that of the control group.2.MDSCs level is associated with disease progression in patients with diffuse large B-cell lymphoma.In the newly diagnosed patients with diffuse large B-cell lymphoma,the level of MDSCs in patients with stage ? and IV diffuse large B-cell lymphoma was significantly higher than that in patients with stage ? and ? diffuse large B-cell lymphoma.The level of MDSCs in patients with diffuse large B-cell lymphoma with IPI score 3-5 was significantly higher than that in patients with IPI score 0-2;The level of MDSCs in patients with diffuse large B-cell lymphoma was significantly higher than that in patients with normal serum LDH.The level of MDSCs in peripheral blood of patients with diffuse large B-cell lymphoma was not significantly correlated with sex,age and B symptoms.3.The proportion of MDSCs in peripheral blood of patients with diffuse large B-cell lymphoma was negatively correlated with OS.Kaplain-Meier survival analysis showed that the prognosis of patients with diffuse large B-cell lymphoma with MDSCs higher than 26.03% was worse.4.Univariate analysis showed that,Ann Arbor stage ?-?,increased LDH level,IPI3-5 and MDSCs ? 26.03% were independent prognostic factors in patients with diffuse large B-cell lymphoma.The indexes with statistical significance of univariate analysis results were incorporated into Cox regression model for multivariate analysis.The results showed that IPI 3-5 and MDSCs ? 26.03% were the prognostic factors of patients with diffuse large B-cell lymphoma.Conclusion The expression of MDSCs was significantly increased in patients with diffuse large B-cell lymphoma,which was correlated with clinical stage,LDH and IPI scores,and could indicate the prognosis of patients with diffuse large B-cell lymphoma.By down-regulating the number or function of MDSCs,it will be beneficial to improve the anti-tumor immune function of the body.Therefore,MDSCs may be a new prognostic indicator for patients with diffuse large B-cell lymphoma,and blocking or clearing MDSCs may improve the prognosis of patients with diffuse large B-cell lymphoma. |
PDF Full Text Request