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A New Immunological Prognostic Model Based on Immunohistochemistry for Extranodal Natural Killer/T-Cell Lymphoma Patients After Non-Anthracycline-Based Chemotherapy.

非蒽环类药物化疗后结外自然杀伤/T 细胞淋巴瘤患者基于免疫组织化学的新免疫学预后模型。

  • 影响因子:2.42
  • DOI:10.2147/CMAR.S244176
  • 作者列表:"Lam ST","Huang H","Fang X","Wang Z","Hong H","Ren Q","Tian Y","Lin S","Lin T
  • 发表时间:2020-03-17
Abstract

Purpose:Programmed death ligand 1 (PD-L1) has been proposed as an important prognostic factor in many types of cancer. However, the role of predicting the prognosis of PD-L1 in extranodal natural killer/T-cell lymphoma (ENKTL) was controversial. Combining other biomarkers might enhance its predictive power. This study aims to evaluate the prognostic value of PD-L1 in conjunction with tumor-infiltrating FoxP3+Tregs for ENKTL after non-anthracycline-based chemotherapy. Patients and Methods:A total of 81 patients with ENKTL were included in this study. Clinicopathological characteristics were collected, and prognostic significance of PD-L1 in neoplastic cells (nPD-L1) and tumor-infiltrating FoxP3+Tregs were evaluated. Results:Patients with nPD-L1-positive had significantly inferior overall survival (OS) and progression-free survival (PFS) compared with nPD-L1-negative (3-year OS, 37.2% vs 67.3%, p = 0.014; 3-year PFS, 31.0% vs 61.8%, p =0.010, respectively). Patients who had low FoxP3+Tregs had significantly inferior OS and PFS compared with high FoxP3+Tregs (3-year OS, 36.4% vs 63.0%, p = 0.004; 3-year PFS, 31.7% vs 56.3%, p = 0.020, respectively). The results of multivariate analysis showed that nPD-L1 positivity (HR 6.629, 95% CI 1.966-22.350, p=0.002) and low FoxP3+Tregs (HR 7.317, 95% CI 2.154-24.855, p=0.001) were independent predictors of inferior OS. Using these 2 variables, we constructed a new prognostic model that singled out 3 groups with different risk profiles: group 1, no adverse factors; group 2, 1 adverse factor; and group 3, 2 adverse factors. The 3-year OS rates of group 1, group 2, and group 3 were 93.3%, 46.6% and 20.8%, respectively (p<0.001), and the 3-year PFS rates were 86.7%, 40.8% and 15.0%, respectively (p=0.001). Conclusion:This study is the first to validate the prognostic value of nPD-L1 and tumor-infiltrating FoxP3+Tregs in ENKTL; the new immunological prognostic model might be used to stratify ENKTL patients in clinical trials for new therapeutic strategies.

摘要

目的: 程序性死亡配体 1 (PD-L1) 被认为是多种癌症的重要预后因子。然而,预测结外自然杀伤/T 细胞淋巴瘤 (ENKTL) PD-L1 预后的作用存在争议。结合其他生物标志物可能会增强其预测能力。本研究旨在评估 PD-L1 联合肿瘤浸润 FoxP3 + Tregs 对非蒽环类药物化疗后 ENKTL 的预后价值。 患者和方法: 本研究共纳入 81 例 ENKTL 患者。收集临床病理特征,评估肿瘤细胞 (PD-L1) 和肿瘤浸润 FoxP3 + Tregs 中 nPD-L1 的预后意义。 结果: nPD-L1-positive 患者总生存期 (OS) 和无进展生存期 (PFS) 明显低于 nPD-L1-negative (3 年 OS,37.2% vs 67.3%,p = 0.014); 3 年 PFS,分别为 31.0% vs 61.8%,p = 0.010)。与高 FoxP3 + Tregs 相比,低 FoxP3 + Tregs 患者的 OS 和 PFS 显著较差 (3 年 OS,36.4% vs 63.0%,p = 0.004; 3 年 PFS,分别为 31.7% vs 56.3%,p = 0.020)。多因素分析结果显示,nPD-L1 阳性 (HR 6.629,95% CI 1.966-22.350,p = 0.002) 和低 FoxP3 + Tregs (HR 7.317,95% CI 2.154-24.855, p = 0.001) 是下位 OS 的独立预测因子。使用这两个变量,我们构建了一个新的预后模型,挑出 3 组具有不同的风险特征: 1 组,无不良因素; 2 组,1 个不良因素; 3 组,2 不利因素。组 1 、组 2 、组 3 的 3 年 OS 率分别为 93.3% 、 46.6% 、 20.8% (p<0.001),3 年 PFS 率分别为 86.7% 、分别为 40.8% 和 15.0% (p = 0.001)。 结论: 本研究首次验证了 ENKTL 中 nPD-L1 和肿瘤浸润 FoxP3 + Tregs 的预后价值; 新的免疫学预后模型可能用于临床试验中对 ENKTL 患者进行分层,以寻求新的治疗策略。

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