Expression Of PIK3CD In Diffuse Large B-cell Lymphoma And Its Clinical Significance

Objective:The expression of PIK3CD(phosphoinositide 3-kinase catalytic subunit delta)in patients with Diffuselarge B cell lymphoma(DLBCL)was detected,and the relationship between the expression of PIK3CD and the clinical characteristics and prognosis of patients with diffuse B-cell lymphoma was initially studied.Methods:Paraffin-embedded tissue samples of 54 patients with diffuse large B-cell lymphoma diagnosed from January 2010 to January 2019 were collected from the Medical Affiliated Hospital of Zunyi Medical University and their PIK3CD expression levels were detected by immunohistochemical methods.The total score obtained by multiplying the percentage of cells by the strength of cell staining is used to determine the expression level of the above indicators.Rank sum test was used to analyze the expression of PIK3CD in DLBCL and 20 cases of reactive lymphadenitis as control group.The clinical characteristics of patients with DLBCL were retrospectively analyzed,and the relationship between PIK3CD expression and clinical characteristics was analyzed by Mann-Whitney U test,the survival curve was analyzed using the Kaplan-Meier method,and the risk factors affecting prognosis were analyzed by COX regression.Results:In 54 DLBCL tissues,PIK3CDs were all expressed,of which 19 were weakly positive(35.2%),16 were positive(29.6%),and 19 were strongly positive(35.2%).There were 7 cases(35.0%)of PIK3CD positive expression in 20 cases of lymphadenitis tissue,all of which were weakly positive,and 13 cases(65%)of negative expression.The difference was statistically significant,P<0.05.The ratio of male to female was 2.85:1,the median age at onset was 52.5 years(25to 78 years),and the median follow-up time was 49 months(8.3 to 89.7 months).All PIK3CD positive expressions in DLBCL was divided into weak positive,positive,and strong positive,and their relationship with clinical characteristics was shown in the the comparison of sex,age,immune phenotype,B symptoms,Ki-67 value,chemotherapy regimen,BCL-2 expression,BCL-6 expression,ECOG score,bone marrow infiltration,extranodular involvement,recurrence,the expression of PIK3CD was not statistically significant(P>0.05).There were 8 cases,13 cases and 18 cases of weak positive,positive and strong positive expression of PIK3CD in???patients.There were 11cases,3 cases and 1 case of weak positive,positive and strong positive PIK3CD expression in???period.The difference was statistically significant(P<0.05).There were 3 cases,10 cases,12 cases,16 cases,6 cases and 7 cases of PIK3CD weak positive,positive and strong positive in DLBCL patients with LDH larger than normal group(P<0.05).PIK3CD was weakly positive,positive,and strong positive in DLBCL patients with LDH greater than the normal value group,and there were 3,10,and 12 positive,respectively,and less than the normal value group.There were 16 cases,6 cases,and 7cases,the difference was statistically significant(P<0.05).There were 4 cases,10 cases,and 13 cases of PIK3CD weak positive,positive,and strong positive with IPI score?3,and 15 cases,6 cases,and 6 cases of PIK3CD weak positive,positive,and strong positive respectively with IPI score<3.Statistical significance(P<0.05).In the efficacy group(complete remission+partial remission),PIK3CD was weakly positive,positive,and strong positive in 14 cases,8 cases,and 6 cases,respectively,and ineffective group(stable or progressive disease)were PIK3CD weakly positive,positive,and strong positive in 5 cases.,8 cases,13 cases,the difference was statistically significant(P<0.05).Kaplan-Meier survival analysis was used to analyze the overall survival(OS)of the patients.The results showed that the overall median survival time was 49 months(8.3 to89.7 months).The intensity of PIK3CD expression was correlated with the patient's prognosis,the difference was statistically significant(P<0.05)The log rank method was used to compare PIK3CD strong,positive,and weakly positive groups,and the significance level was adjusted by Bonferroni.The corrected significance level was approximately 0.0167.There was a statistically significant difference in the survival distribution of PIK3CD expression between the strong positive and weak positive groups(?~2=7.606,P<0.001).There was no significant difference in the survival distribution of PIK3CD expression between the strong positive group and the positive group(?~2=1.392,P=0.238),and between the positive group and the weak positive group(?~2=3.879,P=0.049).Using COX regression multivariate analysis,the analysis of influencing factors on OS showed that PIK3CD overexpression were influential factors for OS independent prognosis(P<0.05).Conclusion:1.Compared with reactive lymphadenitis tissue,PIK3CD is highly expressed in DLBCL tissue.2.PIK3CD expression is associated with clinical staging,LDH,IPI score,and initial treatment efficacy as well as total survival time of disease prognosis in diffuse large B cell lymphoma,and strong positive expression of PIK3CD indicates poor prognosis in DLBCL patients.3.PIK3CD overexpression is an independent risk factor for OS in patients with DLBCL.