Abstract

目的分析肿瘤免疫耐受信号通路的重要因子PD-1和PTEN在经典型霍奇金淋巴瘤(CHL)患者中的表达及其与患者临床特征和预后的相关性。方法回顾性分析2003年2月至2013年8月诊治的56例CHL患者的临床资料。采用免疫组织化学染色法检测CHL患者PD-1和PTEN蛋白的表达,采用原位杂交法检测EBV及EBV编码的小mRNA(EBER),并结合患者的临床特征与生存状态进行相关性分析。结果①56例患者中,男34例,女22例,中位年龄25(7~71)岁,PTEN阳性者11例(19.64%),PD-1阳性者14例(25.00%)。②PTEN和PD-1表达呈正相关(rs=0.320,P=0.016);PTEN表达与Ann Arbor分期、IPS评分和有无大包块(≥5 cm)明显相关,PD-1仅与有无大包块相关(P值均<0.05)。③中位随访43(5~86)个月,多因素分析结果显示:年龄≥45岁(P<0.001)、IPS评分>2分(P=0.026)、EBER阳性(P=0.004)、PTEN蛋白高表达(P=0.035)是影响患者5年总生存的不良预后因素,也是影响5年无进展生存的不良预后因素(P值分别为0.007、0.014、0.002、0.024)。结论肿瘤免疫逃逸信号通路因子PTEN与CHL患者的预后相关,对CHL患者的预后判断有一定作用,同时也为CHL的免疫治疗提供了新思路和理论依据。

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