Objective: To observe the expression levels of PD-1/PD-L1 costimulatory molecules and explore the clinical significance in patients with chronic lymphocytic leukemia (CLL) . Methods: The expression of PD-1/PD-L1 in peripheral blood CD8(+) T cells, CD4(+)T cells, CD19(+)B, and dendrites cells (DC) was detected by flow cytometry in 57 CLL patients and 20 healthy controls. The correlations of PD-1/PD-L1 expression with disease stage, CD38 expression, ZAP-70 expression, chromosome karyotype abnormality and β(2)-MG expression were analyzed. Results: ①Compared with control, CLL patients, including 39 males and 18 females with the median age of (63.7±10.7) years, had no statistically significant difference in age and gender (P>0.05) . CLL patients had the higher PD-1/PD-L1 expression than healthy controls (P<0.05) . ②In Rai staging, the later the stage, the higher expression of PD-1/PD-L1 (P<0.05) . ③PD-1 expression in CD8(+)CD38(+) group (11 cases) was higher than that in CD8(+)CD38(-) group (46 cases) (P=0.004) , and CD8(+) poor prognosis chromosome group (14 cases) also had significant higher PD-1 expression than CD8(+)good prognosis chromosome group (28 cases) (P=0.004) . ④The expression of PD-L1 was higher in CD38(+)group, ZAP-70(+)group, and poor prognosis group, as compared to that in CD38(-)group (P=0.002) , in ZAP-70(-)group (P<0.001) , in good prognosis group (P=0.023) . There was no correlation between the expression of PD-1/PD-L1 and β(2)-MG (P>0.05) . Conclusion: This data reveals that PD-1/PD-L1 was highly expressed in CLL patients. Its expression levels were correlated with Rai stage, CD38, ZAP-70, chromosome karyotype, but not with β(2)-MG. PD-1/PD-L1 may be a prognostic factor in patients with CLL.
目的：观察程序性死亡受体1/及其配体（PD-1/PD-L1）共刺激分子在慢性淋巴细胞白血病（CLL）患者中的表达水平，并探讨其可能的临床意义。方法：以57例CLL患者为研究对象，以20名健康体检者为对照，采用流式细胞术分别检测其外周血CD8(+)、CD4(+)T细胞和CD19(+)B细胞中PD-1的表达水平，以及树突细胞（DC）中PD-L1的表达水平；同时分析PD-1/PD-L1表达与疾病分期、CD38表达、ZAP-70表达、染色体核型异常、β(2)微球蛋白（β(2)-MG）表达水平的相关性。结果： ①CLL患者组中男39例，女18例，平均年龄（63.7±10.7）岁。与对照组比较，年龄、性别差异无统计学意义（P值均>0.05）；CLL患者组外周血中PD-1、PD-L1的表达均高于对照组（P值均<0.05）。②在Rai分期低、中、高危组中，随着危险度的增高PD-1、PD-L1的表达水平亦增高（P值均<0.05）。③PD-1表达在CD8(+)CD38(+)组（11例）高于CD8(+)CD38(-)组（46例）（P=0.004），在CD8(+)预后不良染色体组（14例）高于CD8(+)预后良好染色体组（28例）（P=0.004）。④PD-L1表达在CD38(+)组（11例）高于CD38(-)组（46例）（P=0.002），在ZAP-70(+)组（11例）高于ZAP-70(-)组（28例）（P<0.001），在预后不良染色体组（14例）高于预后良好染色体组（28例）（P=0.023）。PD-1、PD-L1表达与β(2)-MG表达无相关性（P值均>0.05）。结论： PD-1、PD-L1在CLL患者体内存在高表达，其表达水平与疾病分期、CD38表达、ZAP-70表达、染色体核型等预后指标存在一定的相关性，与β(2)-MG表达无相关性，提示其有可能作为评估CLL患者预后的指标。.
Keywords: Antigens, CD274; Leukemia, lymphocytic, chronic, B-cell; Programmed cell death 1 receptor.