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目的:通过检测程序性死亡分子1(PD-1)、程序性死亡-配体1 (PD-L1)在急性淋巴细胞白血病(ALL)患儿骨髓单个核细胞中的表达水平，探讨PD-1/PD-L1信号通路在儿童ALL中的作用机制以及其作为潜在治疗靶点和预后预测指标的可行性，为儿童ALL的诊疗提供新思路。方法:收集郑州大学第一附属医院2018年9月至2019年7月收治的59例ALL患儿骨髓标本，应用流式细胞术检测59例ALL患儿(包括初诊ALL 47例，复发ALL 12例)初诊时、诱导治疗后、早期强化治疗后骨髓单个核细胞中PD-1、PD-L1的表达，并收集患儿的相关临床资料，以同期收治的15例非恶性血液疾病患儿骨髓标本为对照组。结果:PD-1在初诊组、复发组及对照组患儿骨髓单个核细胞中的表达差异无统计学意义(n H＝2.402，n P>0.05)，PD-L1在复发组[(7.32±3.60)%]和初诊组[(3.18±2.37)%]的表达率均大于对照组[(0.84±0.39)%]，差异有统计学意义(n H＝28.048，n P诱导治疗后(n B＝0.036)>早期强化治疗后(n B＝0.000)，提示随着治疗的推进呈下降趋势；PD-L1的表达在低危组(n B＝-3.912)<中危组(n B＝-3.595)0.05). The expression of PD-L1 in the relapsed and refractory group [(7.32±3.60)%] and the newly diagnosed group [(3.18±2.37)%] was higher than that in the control group [(0.84±0.39)%], and the differences were statistically significant (n H= 28.048, n P<0.05). In the initial treatment group, the expression of PD-L1 in the bone marrow mononuclear cells was the strongest expression before treatment (n B=1.293), followed by after induction treatment (n B=0.036) and after early intensive treatment (n B=0.000), suggesting that there was a downward trend as the continued treatment.The expression of PD-L1 was the weakest expression in the low-risk group (n B=-3.912) than in the medium-risk group (n B=-3.595) and high-risk group (n B=0.000), revealing that the expression of PD-L1 is related to the risk grades of ALL.The higher the risk rating is, the higher the PD-L1 protein expression is.n Conclusions:The high expression of PD-L1 may be involved in the pathogenesis and be used as an adverse predictor of ALL childhood and an evaluation index of chemotherapy efficacy.PD-1 / PD-L1 signaling pathway may be a potential therapeutic target of ALL childhood.