Department of Pathology, Yıldırım Beyazıt University, Ankara, Turkey.
Department of Hematology, Yıldırım Beyazıt University, Ankara, Turkey.
Clin Lymphoma Myeloma Leuk. 2020 Jul;20(7):e375-e381. doi: 10.1016/j.clml.2019.11.021. Epub 2020 Feb 6.
The programmed death receptor (PD-1) and ligand (PD-L1) pathway act by suppressing the antitumor response in chronic Hodgkin lymphoma (cHL). In this study, we aimed to investigate the effect of PD-1, PD-L1, and Epstein-Barr virus (EBV) positivity on prognosis at the initial diagnosis of cHL.
Thirty-six patients with cHL were retrospectively analyzed. PD-L1 staining was performed for RS cells and tumor microenvironment in the biopsy materials of cases. The presence of EBV was investigated by EBER (EBV-encoded RNA) method in tumor cell. P < .05 was accepted as significant.
The presence of advanced-stage disease, B symptoms, intermediate or high-risk international prognostic index (IPS), and extranodal involvement were found to be related to both PD-L1 positivity and EBV positivity in RS cells. PD-L1 positivity in RS cells was also associated with EBV positivity. There were 6 (16.7%) triple-positive (EBV, RS-PD-L1, mic-PD-1) patients. All of these patients had advanced-stage disease, B symptoms at the time of diagnosis, and intermediate-high IPS score, and 4 of 6 patients had extranodal involvement. This group also had significantly shortened overall survival compared with others (38.4 months vs. 67.9 months P = .024).
Our data suggest that there is correlation between PD-L1 positivity and EBV positivity in tumor RS cells that are also associated with extranodal involvement, intermediate and high IPS score, presence of B symptoms, and advanced-stage disease. In addition, we identified a group of triple-positive (EBV, RS-PD-L1, mic-PD-1) cHL patients who have a very high-risk disease.
程序性死亡受体（PD-1）及其配体（PD-L1）通路通过抑制慢性霍奇金淋巴瘤（cHL）中的抗肿瘤反应起作用。在这项研究中，我们旨在研究 PD-1、PD-L1 和 Epstein-Barr 病毒（EBV）阳性在 cHL 初始诊断时对预后的影响。
回顾性分析 36 例 cHL 患者。对病例活检材料中的 RS 细胞和肿瘤微环境进行 PD-L1 染色。通过肿瘤细胞中的 EBER（EBV 编码的 RNA）方法检测 EBV 的存在。P<0.05 为有统计学意义。
晚期疾病、B 症状、中高危国际预后指数（IPS）和结外累及的存在与 RS 细胞中 PD-L1 阳性和 EBV 阳性均相关。RS 细胞中 PD-L1 阳性也与 EBV 阳性相关。有 6 例（16.7%）为三阳性（EBV、RS-PD-L1、mic-PD-1）患者。所有这些患者均有晚期疾病、诊断时的 B 症状和中高危 IPS 评分，6 例中有 4 例有结外累及。与其他患者相比，该组的总生存率明显缩短（38.4 个月比 67.9 个月，P=0.024）。
我们的数据表明，肿瘤 RS 细胞中 PD-L1 阳性与 EBV 阳性之间存在相关性，并且与结外累及、中高危 IPS 评分、B 症状存在和晚期疾病相关。此外，我们发现了一组三阳性（EBV、RS-PD-L1、mic-PD-1）cHL 患者，他们患有极高危疾病。
