PD-L1、PD-L2、CD30、CD23和BCL-6在原发纵隔大B细胞淋巴瘤诊断和预后评估中的应用价值

目的 探讨治疗相关标志物PD-L1、PD-L2、CD30、CD23、BCL-2、BCL-6、MUM1和GATA3在原发纵隔大B细胞淋巴瘤（PMBL）诊断和预后评估中的应用价值。方法 收集PMBL的34例患者进行回顾性研究，31例非纵隔原发的非特指型弥漫性大B细胞淋巴瘤（DLBCL-NOS）作为对照组，免疫组织化学染色方法检测8种蛋白的表达情况。结果 PD-L1、PD-L2和CD30在PMBL组阳性肿瘤细胞百分比的中位数分别为70%（30%, 90%）、25%（0, 70%）和17.5%（0, 60%），显著高于DLBCL-NOS组，差异有统计学意义（P<0.05）；CD30和CD23在PMBL组的阳性率分别为61.76%（21/34）和76.47%（26/34），与DLBCL-NOS组之间差异有统计学意义（P=0.000）。伴有CD30或BCL-6表达的PMBL患者生存曲线尽管P>0.05，仍显示出预后差的趋势。结论 PMBL中PD-L1、PD-L2和CD30的表达水平较高，有助于精准识别更多可能对免疫或靶向治疗有反应的患者。免疫组织化学标记PD-L1、PD-L2、CD30和CD23有助于PMBL与DLBCL-NOS鉴别诊断。CD30和BCL-6作为PMBL的候选预后指标应该在更大量的样本中进一步研究。

Application of PD-L1, PD-L2, CD30, CD23 and BCL-6 in Diagnosis and PrognosticEvaluation of Primary Mediastinal Large B-cell Lymphoma

Objective To explore the application value of treatment-related markers PD-L1, PD-L2, CD30, CD23, BCL-2, BCL-6, MUM1 and GATA3 in the diagnosis and prognostic evaluation of primary mediastinal B-cell lymphoma(PMBL). Methods A retrospective study was conducted on 34 patients diagnosed with PMBL, and 31 patients with DLBCL-NOS which was not primary in the mediastinum were taken as control group. The expressions of 8 proteins were detected by IHC staining. Results The median percentages of tumor cells with PD-L1, PD-L2 and CD30 expression in PMBL group were 70% (30%, 90%), 25% (0, 70%) and 17.5% (0, 60%) respectively, which were significantly higher than those in the DLBCL-NOS group (P<0.05). The positive rates of CD30 and CD23 in PMBL group were 61.76% (21/34) and 76.47% (26/34) respectively, significantly different with those in the DLBCL-NOS group (P=0.000). The survival curve of PMBL patients with CD30 or BCL-6 expression showed a trend of poor prognosis, despite the P value was >0.05. Conclusion The high expression levels of PD-L1, PD-L2 and CD30 in PMBL are helpful to accurately identify more patients who may respond to immune or targeted therapy. Immunohistochemical staining of PD-L1, PD-L2, CD30 and CD23 is helpful for the differential diagnosis of PMBL and DLBCL-NOS. As candidate prognostic indicators of PMBL, CD30 and BCL-6 should be further studied in a larger number of samples.