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. 2025 Jul 6;16(1):1270.
doi: 10.1007/s12672-025-03062-5.

p53/PD-L1 co-expression predicts poor prognosis in diffuse large B-cell lymphoma

Yaoyao Jing #  1   2   3   4 , Ying Yuan #  5 , Yong Yu  2   3   4   6 , Haifeng Zhao  2   3   4   6 , Hongliang Yang  2   3   4   6 , Xiaofang Wang  7   8   9   10
Affiliations

p53/PD-L1 co-expression predicts poor prognosis in diffuse large B-cell lymphoma

Yaoyao Jing et al. Discov Oncol. .

Abstract

Objective: To investigate the clinical characteristics and survival of p53 and Programmed death-ligand 1 (PD-L1) co-expression in diffuse large B-cell lymphoma (DLBCL) patients.

Methods: Immunohistochemistry (IHC) was used to detect the expression of p53 and PD-L1 in tumor cells of 176 patients with DLBCL. Clinical data were retrospectively examined along with long-term follow-up. Correlation between the expression of p53 and PD-L1 and the clinicopathological characteristics of the patients was assessed. Impact of Rituximab (R) on prognosis among DLBCL patients with positive expression of p53 and PD-L1 was evaluated.

Results: p53 expression, PD-L1 expression, and p53/PD-L1 co-expression were present in 44.9%, 42.0%, and 25.6% of patients with DLBCL, respectively. No significant differences existed in the clinicopathological characteristics between patients with positive and negative p53 expression and between patients with positive and negative PD-L1 expression. However, more co-expression of p53/PD-L1 was observed in patients with non-germinal center B-cell-like (non-GCB) subtypes (p = 0.005). There was a significant positive correlation between p53 and PD-L1 expression (r = 0.273, p < 0.001). Survival analysis indicated that patients exhibiting p53/PD-L1 co-expression had decreased progression-free survival (PFS) and overall survival (OS ) compared to those demonstrating positive expression of either p53 or PD-L1, and in addition, both negative p53/PD-L1 expression. Rituximab failed to substantially modify the prognosis of patients. p53/PD-L1 co-expression is an independent indicator of adverse prognosis.

Conclusions: Co-expression of p53/PD-L1 in DLBCL patients implies an unfavorable prognostic group, which doesn't derive benefit from Rituximab.

Keywords: Diffuse large B-cell lymphoma; PD-L1; Prognosis; Rituximab; p53; p53/PD-L1 co-expression.

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Conflict of interest statement

Declarations. Ethics approval: Studies involving human participants were approved and reviewed by the Medical Ethics Committee of Tianjin Medical University Cancer Institute & Hospital. The research was carried out following the guidelines of the ethics committee listed in the ethics statement. Consent to participate: Informed consent has been obtained from the patients for the study. Consent to publish: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Immunohistochemical staining of p53 and PD-L1 expression in DLBCL tumour tissues. (A) Representative patterns of positive p53 expression (x200 and x400). (B) Representative patterns of positive PD-L1 expression (x200 and x400)
Fig. 2
Fig. 2
Survival of 176 DLBCL patients according to p53 and PD-L1 expression. (A, D) DLBCL patients of p53 positive expression had a significantly poorer OS and PFS than p53 negative expression. (B, E) PD-L1 positive expression had worse OS and PFS than patients with PD-L1 negative expression. (C, F) Patients with p53/PD-L1 co-expression had a shorter OS and PFS than single positive expression of PD-L1 or p53 and both-negative group
Fig. 3
Fig. 3
Multivariate analysis of prognostic factors in DLBCL. (A) OS. (B) PFS
Fig. 4
Fig. 4
Prognostic significance of Rituximab in patients with the expression of p53 and PD-L1. For patients with p53 expression (A, D), PD-L1 expression (B, E), and p53/PD-L1 co-expression (C, F), treated with Rituximab did not have a survival benefit
See this image and copyright information in PMC

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