Ma Xin-Jian, Zhang Fu-Hua, Sun Li
Department of Clinical Laboratorial Examination, Hekou District Hospital of Traditional Chinese Medicine,Dongying 257234,Shandong Province, China.
Department of Hematology,Dongying People's Hospital,Dongying 257091, Shandong Province, China.
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2017 Oct;25(5):1384-1389. doi: 10.7534/j.issn.1009-2137.2017.05.018.
To explore the expression and clinical significance of PD-L1, heat shock protein 90 (HSP90) and HSP90α in the serum of patients with acute leukemia (AL) of different types and disease stages.
A total of 84 AL patients from January 2013 to October 2016 in our hospital and 20 healthy persons as controls were selected. All the samples of serum or bone marrow were separated. The protein expression levels of serum HSP90, HSP90α were detected by ELISA. The flow cytometry was used to detect PD-L1 expression. The relationship of the expression level of PD-L1, HSP 90, and HSP90α with clinical outcome was analyzed.
The expression levels of serum HSP90, HSP90α and PD-L1 positive rate in AL patients were significantly higher those that in control group (P<0.05), the expression levels of serum HSP90, HSP90α and PD-L1 positive rate of Al patients in remission were lower than those in newly diagnosed patients (P<0.05). The expression level of HSP90, HSP90α and PD-L1 positive rate in the relapsed AL patients were higher than those in newly diagnosed AL patients and patients in remission (P<0.05). There was no significant difference of HSP90 protein level and PD-L1 positive rate between newly diagnosed AML patients and ALL patients(P>0.05). HSP90α level of newly diagnosed AML patients was lower than that in newly diagnosed ALL (P<0.05). HSP90α and HSP90 levels and PD-L1 positive rate in no remission patients were significantly higher than those in complete remission patients (P<0.05). The HSP90α level in patients without recurrence decreased during chemotherapy. The HSP90α protein level was the lowest after the hematopoietic stem cell transplantation, but increased after relapse.
The PD-L1,HSP90 and HSP90α play an important role in the developmental process of acute leukemia, which can be used as reference indications to assess clinical efficacy and prognosis.
探讨不同类型及疾病分期的急性白血病（AL）患者血清中程序性死亡受体配体1（PD-L1）、热休克蛋白90（HSP90）及热休克蛋白90α（HSP90α）的表达情况及其临床意义。
选取2013年1月至2016年10月在我院就诊的84例AL患者，并选取20例健康者作为对照。分离所有血清或骨髓样本。采用酶联免疫吸附测定（ELISA）法检测血清HSP90、HSP90α的蛋白表达水平。采用流式细胞术检测PD-L1表达。分析PD-L1、HSP90及HSP90α表达水平与临床结局的关系。
AL患者血清HSP90、HSP90α表达水平及PD-L1阳性率均显著高于对照组（P<0.05），缓解期AL患者血清HSP90、HSP90α表达水平及PD-L1阳性率低于初诊患者（P<0.05）。复发AL患者HSP90、HSP90α表达水平及PD-L1阳性率高于初诊AL患者及缓解期患者（P<0.05）。初诊急性髓系白血病（AML）患者与急性淋巴细胞白血病（ALL）患者的HSP90蛋白水平及PD-L1阳性率比较，差异无统计学意义（P>0.05）。初诊AML患者的HSP90α水平低于初诊ALL患者（P<0.05）。未缓解患者的HSP90α、HSP90水平及PD-LI阳性率显著高于完全缓解患者（P<0.05）。未复发患者化疗期间HSP90α水平下降。造血干细胞移植后HSP90α蛋白水平最低，但复发后升高。
PD-L1、HSP90及HSP90α在急性白血病发生发展过程中起重要作用，可作为评估临床疗效及预后的参考指标。
