EBV Positivity and Programmed Death-ligand 1 Expression in Diffuse Large B-cell Lymphoma: A Systematic Review


Anticancer Res. 2020 Nov;40(11):5951-5968. doi: 10.21873/anticanres.14616.


BACKGROUND/AIM: Diffuse large B-cell lymphoma (DLBCL) is the most common form of non-Hodgkin lymphoma. A systematic review to evaluate the association between Epstein-Barr Virus (EBV) and programmed death ligand-1 (PD-L1) in DLBCL biopsy was conducted.

MATERIALS AND METHODS: Only studies comparing EBV+ and EBV- groups were eligible following database search. Prevalence ratios were calculated for results comparison. The EBV impact on PD-L1 positivity in tumour cells and its microenvironment was analysed.

RESULTS: With 270 records screened, eleven cross-sectional studies were identified for final review. Eight studies investigated PD-L1 expression in tumour cells and found an EBV trend unlikely, while four studies found an increase in its expression in the tumour microenvironment. Nine studies showed that EBV+ cases were more commonly of non-germinal centre B-cell origin. Four studies examined genetic aberrations, but no definite consensus was reached.

CONCLUSION: A non-EBV related mechanism is likely related to increased PD-L1 expression, with relevance to the cell of origin.