Expression And Clinical Significance Of CMTM6 And PD-L1 In Diffuse Large B Cell Lymphoma

Objective To investigate the expression of CMTM6 and PD-L1 protein in diffuse large B cell lymphoma(DLBCL)and their relationship with clinical features.Methods Fifty-three patients newly diagnosed as DLBCL in the Department of Hematology of our hospital from June 2017 to September2020 were collected,and 20 patients with lymphadenitis in the same period were selected as the control group.Immunohistochemistry(IHC)was used to detect the expression of CMTM6 and PD-L1 in DLBCL.Meanwhile,the relationship between the expression of CMTM6 and PD-L1 and clinical data of DLBCL patients,such as gender,age,classification,stage and international prognostic index,was also analyzedResults 1.A total of 53 patients with DLBCL were collected.The age of onset ranged from 10 to 88 years old.The median age of onset was 68 years old.The ratio of male to female was about 1.8:1.According to gender,age,Hans immune classification,Ann Arbor stage,IPI score,ECOG score,B symptom,LDH and Ki67 expression level,they were divided into different groups: 17 cases(32.1%)in young group(≤60 years)and 36 cases(67.9%)in old group(> 60 years);34 cases(64.2%)in male and 19 cases(35.8%)in female;39 cases(73.6%)in GCB type,14 cases(26.4%)in non-GCB type;In Ann Arbor stage,25 cases(47.2%)were in stage I / II(early stage)and 28 cases(52.8%)were in stage III / IV(advanced stage);According to IPI score,34 cases(64.2%)scored 0-2(low-risk group)and19 cases(35.8%)scored 3-5(high-risk group);34 cases(64.2%)without B symptoms(fever,night sweats and emaciation),19 cases(35.8%)with B symptoms;According to ECOG score,34 cases(64.2%)scored < 2 and 19cases(35.8%)scored ≥2;LDH was normal in 24 cases(45.3%),elevated in27 cases(50.9%)and decreased in 2 cases(3.8%);Ki67 was low in 8 cases(15.1%)and high in 45 cases(84.9%).2.The positive rate of CMTM6 in DLBCL group was 58.5%(31/53),which was significantly higher than 30%(6/20)in control group(P = 0.03).The expression of CMTM6 was significantly correlated with Ann Arbor stage and IPI prognosis score(P<0.01).The positive expression rate of CMTM6 in Ann Arbor stage Ⅲ/Ⅳ(advanced stage)was significantly higher than that in stage Ⅰ/Ⅱ(early stage),The positive rates were 89.3%and 24.0%.The positive rate of CMTM6 in IPI 3-5(high risk group)was higher than that in IPI 0-2(low risk group),The positive rates were 89.5%and 41.2%.The difference between the two indicators was statistically significant(P<0.01).The expression of CMTM6 protein was not correlated with gender,age,classification,ECOG score,B symptom,LDH and Ki67(P> 0.05).3.In DLBCL group,The positive rate of PD-L1 was 64.2%(34 / 53).The positive rate of the control group was 35%(7 / 20).The expression rate of PD-L1 in DLBCL group was significantly higher than that in control group(P=0.025).PD-L1 protein expression was significantly different in Ann Arbor stage,IPI prognosis score,ECOG,B symptom and LDH(P<0.05).PD-L1 protein expression was significantly higher in Ann Arbor stage III / IV(advanced stage),IPI 3-5(high risk group),ECOG≥2 group,B symptom group and LDH elevated group,and Ann Arbor,IPI,ECOG and LDH were significantly correlated with PD-L1(P<0.01).There was no significant correlation between PD-L1 expression and gender,age,type and Ki67(P> 0.05).4.CMTM6 and PD-L1 were all positive in 24 cases(45.3%)and all negative in 12 cases(22.6%)of DLBCL.According to Spearman rank correlation analysis,CMTM6 was positively correlated with PD-L1(r =0.328,P = 0.016).Conclusions 1.The expressions of CMTM6 and PD-L1 in DLBCL patients were significantly higher than those in the control group,and the expression of CMTM6 was significantly correlated with Ann Arbor stage and IPI prognosis score,PD-L1 protein expression was significantly different in Ann Arbor stage,IPI prognosis score,ECOG,B symptom and LDH.The results suggest that the overexpression of CMTM6 / PD-L1 may be related to the occurrence and development of DLBCL.2.There was a positive correlation between the expression of CMTM6 and PD-L1 in DLBCL tissues,suggesting that CMTM6 / PD-L1co-expressed in DLBCL.They may promote the immune escape of DLBCL cells.