The Significance Of Expressions And Prognosis Study Of CD200 And ICOS In Angioimmunoblast T-cell Lymphom

Objective:To study of the condition of the expressions of CD200 and ICOS in angioimmunoblastic T-cell lymphoma,peripheral T-cell lymphoma,NOS,and classic Hodgkin's lymphoma by the immunohistochemistry detection method;To compare The differences inthe expressionsof CD200,ICOS and CXCL-13,PD-1,CD10,BCL-6and other proteins in AITL;To analyze the relationship between CD200 and ICOS and the prognosis of AITL.Methods:1.Forty patients who diagnosed with AITL by histological morphology and immunohistochemistry in the Chenzhouarea(Chenzhou First People's Hospital,The Third People's Hospital of Chenzhou,The Fourth People's Hospital of Chenzhou and Xiangnan Affiliated Hospital)from June 2012 to December 2019 were collected.The clinical data,follow-up data and tissue samples were collected.After review by two doctors with senior titles,39 patients were diagnosed with AITL.2.Ten patients with CHL and ten patients with PTCL-NOS in the First People's Hospital of Chenzhou from August 2016 to July 2019 were collected,and their tissue specimens were collected.3.By the immunohistochemistry detection method,the condition of the expressions of CD200,ICOS,CXCL-13,PD-1,CD10 and BCL-6 inpatients with AITL was detected.In the same way,the condition of the expressions of CD200 and ICOS protein in patients with CHL and PTCLNOS was detected.4.SPSS.23.0 statistical software was adopted for statistics and analysis.Chi-square test was used to analyze the expressions of CD200 and ICOS proteins in patients with AITL and the gender,age,clinical staging,LDH,hepatosplenomegaly,bone marrow involvement,B symptoms,the comparison of the expression levels of PD-1,CD10,and BCL-6 protein of patients,P <0.05 denotes the difference was statistically significant.5.Kaplan-Meier method was used for univariate survival analysis in terms of expressions of CD200,ICOS,PD-1,CD10 and BCL-6 protein and the gender,age,clinical staging,LDH,hepatosplenomegaly,bone marrow involvement,B symptomsin patients AITL.The survival curve was plotted;The Cox proportional hazard model was used for multivariate analysis,P <0.05,which was statistically significant.Results: 1.The immunohistochemistry results showed that the positive rates of CXCL-13,CD10,PD-1,BCL-6,CD200 and ICOS in patients with AITL were 57.69%(15/26),41.03%(16/39),87.18%(34/39),74.36%(29/39),71.79%(28/39),61.54%(24/39)respectively;The positive rates of CD200 and ICOS in patients with CHL were 70%(7/10)and 0%(0/10)respectively;The positive rates of CD200 and ICOS in patients with PTCL-NOS were 40%(4/10)and 10%(1/10)respectively.2.The differences in the expressions of CD200 and ICOS protein in patients with AITL,CHL,PTCL-NOS were analyzed.The results showed that the difference in the expression of ICOS protein between AITL and CHL(P=0.001)and PTCL-NOS(P=0.004)was statistically significant;However,the difference in the expression of CD200 between AITL and CHL and PTCL-NOS was not statistically significant(P> 0.05).3.The relationship between the expressions of CD200 and ICOS protein,clinical parameters of patients with AITL and the expressions of CD10,PD-1,BCL-6 protein were analyzed.Statistical results showed that the expression of CD200 in patients with LDH(P = 0.012)and IPI score(P = 0.001)had significant differences.However,the expression of CD200 in patients' gender,age,ECOG physical fitness score,clinical staging,extranodal involvement,hepatosplenomegaly,B symptoms and expressions of CD10,PD-1,BCL-6 protein and other parameters had no statistical significance(P> 0.05);The expressions of ICOS in patients with LDH(P = 0.010)and PD-1(P = 0.002)had significant differences.The expression of ICOS in the patient's gender,age,ECOG physical fitness score,clinical staging,extranodal involvement,IPI score,hepatosplenomegaly,B symptoms,expressions of CD10 and BCL-6protein and other parameters had no statistical significance(P> 0.05).4.Kaplan-Meier method univariate survival analysis results showed that the expressions of CD200(P< 0.001),ICOS(P = 0.011),the number of extranodal involvement with ?2(P<0.001),increased LDH(P = 0.002),IPI score with 3 to 5 points(P<0.001)and PD-1(P = 0.048)protein were associated with poor prognosis in patients with AITL;The expression of CD200protein(P<0.001),The number of extranodal involvement with ?2(P = 0.015),increased LDH(P = 0.003),IPI score with 3 to 5 points(P<0.001)and with B symptoms were related to the worsening in patients with AITL.5.The results of multivariate analysis of the COX proportional hazard regression model showed that the expression of CD200 protein was an independent influencing factor for judging the prognosis and progression of patients with AITL(P = 0.001,P = 0.001).Moreover,therisk of death for CD200-positive patients was 13.16(1/0.076)times as much as CD200-negative patients,and the risk of exacerbation was13.33(1/0.075)times;Extranodal involvement was an independent influencing factor for judging the prognosis of patients with AITL(P =0.016).Moreover,the risk of death of patients with extranodal involvement ? 2 was 11.117 times as much as patients with extranodal involvement <2;LDH levels could not be used as an independent influencing factor for judging the prognosis of patients with AITL(P =0.109).Conclusion:1.CD200 and ICOS proteins can be regarded as immunohistochemistry indicators to assist in the diagnosis of AITL.2.The expression of ICOS protein helps to distinguish between AITL and CHL / PTCL-NOS.3.CD200 can be used as an indicator to judge the prognosis and deterioration of AITL patients.It is also an independent influencing factor to judge the prognosis and progression of AITL patients;ICOS can be used as an indicator to judge the prognosis of AITL patients.