| Objective:In this study,we aim to investigate the expression of programmed cell death receptor ligand 1(PD-L1)in the tumor tissue and serum of patients suffered from B-cell non-Hodgkin's Lymphoma(B-NHL)with Hepatitis B Virus(HBV)infection,and to discuss the correlation between PD-L1 and HBx protein,to explore the clinical and prognostic significance of PD-L1 expression in HBV infected B-NHL patients.Methods:A total of 92 newly diagnosed and untreated B-NHL patients with HBV(experimental group)and 33 newly diagnosed B-NHL patients without HBV(control group)were obtained from the Hunan Cancer Hospital.Immunohistochemical staining(EnVision method)was used to detect the expression of PD-L1 and HBx protein,at the same time,47 cases of untreated and serum samples B-NHL with HBV(experimental group).47 newly diagnosed B-NHL patients without HBV who were kept serum samples were the control group(the baseline characteristics of the control group and the experimental group have been screened for 1:1 matching),and ELISA method was used to detect the level of serum soluble PD-L1(sPD-L1).The clinicopathological information and prognostic data of these patients were collected,then chi-square test was performed to explore the correlation of PD-L1 with clinic pathological parameters.The overall survival(OS)and progression-free survival(PFS)of B-NHL patients were analyzed by using Kaplan-Meier.Results:1.HBV~+HBx~+group?HBV~+HBx~-group and HBV negative group were(37.13±2.61)%,(24.39±3.70)%and(3.94±2.08)%,respectively.The results of statistic analysis indicated the expression rate of PD-L1 in HBV~+HBx~+group is higher than HBV~+HBx~-group(p=0.0065)and HBV~-group(p<0.0001),and HBV~+HBx~-group showed higher expression rate of PD-L1 than HBV~-group.(p<0.0001).2.The concentration of sPD-L1 in serum is significantly increased in B-NHL patients with HBV as compared with B-NHL patients without HBV(HBV~+=94.81±64.72 pg/mL,HBV~-=46.55±13.13 pg/mL,p<0.0001).In addition,the expression level of PD-L1 in B-NHL tumor tissue is positively correlated with the concentration of PD-L1 in serum in B-NHL patients with HBV(r=0.6300,p<0.0001).3.The 3-year OS rate in the PD-L1~highigh group,PD-L1~lowow group and PD-L1~-group were 53.1%,70.4%and 87.5%,respectively.The 3-year PFS rate in the PD-L1~highigh group,PD-L1~lowow group and PD-L1~-group were43.8%,65.9%and 81.3%,respectively.4.Survival curve analysis of serum sPD-L1 in HBV positive B-NHL patients showed that the PD-L1~highigh group had a 3-year OS rate of 63.2%and a 3-year PFS rate of 50.0%.The PD-L1~lowow group had a 3-year OS rate of 77.8%and a 3-year PFS rate of 77.8%.Survival analysis of OS and PFS between groups revealed that the p values were 0.024 and 0.047,respectively,and the difference was statistically significant.5.The multi-factor Cox risk model found that the high expression of PD-L1 in the tumor tissue,ECOG?2 scores,late stage disease,and unrelieved chemotherapy are independent risk factors for poor OS.The high expression of PD-L1,advanced disease,and unrelieved chemotherapy are independent risk factors for poor PFS.In the serum sPD-L1 prognosis model,high expression of sPD-L1 and late stage are independent risk factors for patients with poor OS.B Symptom and unrelieved chemotherapy are independent risk factors for patients with poor PFS.Conclusions:1.The expression of PD-L1 in tumor tissue is significantly increased in B-NHL patients with HBV compared with B-NHL patients without HBV.B-NHL patients with HBV showed higher sPD-L1 concentration than B-NHL patients without HBV.2.The expression level of PD-L1 in tumor tissue is positively correlated with the concentration of PD-L1 in serum in B-NHL patients with HBV.3.High expression of PD-L1 is probably an independent prognostic risk factor for OS and PFS in B-NHL patients with HBV. |
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