[Genetic abnormality and protein expression of C-MYC and PD-L1 in ALK-negative anaplastic large cell lymphoma].

To investigate the genetic abnormality and protein expression of C-MYC and PD-L1 in the patients with ALK-negative anaplastic large cell lymphoma (ALKALCL), and to explore their roles in the pathogenesis of ALKALCL and their relationship with clinicopathological characteristics. Thirty-seven cases of ALKALCL diagnosed at Fujian Provincial Hospital from January 2003 to January 2017 were selected. Fluorescence in situ hybridization (FISH) was used to detect the genetic abnormality of C-MYC and PD-L1. The expression of C-MYC and PD-L1 proteins was detected by immunohistochemistry. The relationship between C-MYC and PD-L1 genes' abnormalities and protein expression was analyzed, as well as their associations with various clinicopathological parameters. Among the 37 ALKALCL patients, 17 (45.9%) were positive for C-MYC protein, and 14 (37.8%) were positive for PD-L1 protein. There was a significant correlation between C-MYC protein and PD-L1 protein (=0.990,=0.014). The protein expression of C-MYC and PD-L1 (versus negative) was associated with the clinical stage of ALKALCL, respectively. The international prognosis index (IPI) in high-risk group was higher than that in the low-risk group (<0.05). FISH test showed that 9 (24.3%) of the 37 cases had amplification of C-MYC gene, and no translocation of C-MYC gene was found in any of the cases. Amplification of PD-L1 gene was found in only 2 cases (5.4%). The 3-year overall survival rate of the C-MYC or PD-L1 immunohistochemistry-positive cases was significantly lower than those of the C-MYC or PD-L1 negative cases (<0.01 and <0.05), respectively. The expression of C-MYC and PD-L1 proteins are related to the clinical stage, IPI and overall survival rate of ALKALCL. Thus, it can be used to assess the disease's aggressiveness and to predict the prognosis of ALKALCL. The expression of PD-L1 in ALKALCL may be regulated by C-MYC, thus suggesting a possible design of combined C-MYC targeted therapy and immune checkpoint blocking for some ALKALCL patients.