当代医学
噹代醫學
당대의학
CHINA CONTEMPORARY MEDICINE
2014年
17期
3-4,5
,共3页
弥漫性大B细胞淋巴瘤%利妥昔单抗%Ki-67
瀰漫性大B細胞淋巴瘤%利妥昔單抗%Ki-67
미만성대B세포림파류%리타석단항%Ki-67
Diffuse large B cell lymphoma%Rituximab%Ki-67
目的：探讨利妥昔单抗应用前后Ki-67表达在弥漫性大B细胞淋巴瘤(DLBCL)中的预后意义。方法收集广东医学院附属医院69例接受R-CHOP和50例接受CHOP治疗的DLBCL患者的临床资料，分析Ki-67表达及其与DLBCL预后的关系。结果119例患者中男：女比例为1.83∶1，平均(50.4±12.8)岁，Ki-67高表达(≥85%)患者占28.6%，多见于IPI 3～5分患者（P=0.039），与其他临床特征比较，差异无统计学意义。按治疗方案将患者分为CHOP组和R-CHOP组，2组患者在性别、年龄、B症状、LDH水平、ECOG、病理分期、结外累及、IPI评分及Ki-67表达方面比较，差异无统计学意义，基线资料可比。单因素预后分析显示，Ki-67高表达在CHOP和R-CHOP组均提示不良的OS（P=0.002，0.004）和PFS（P=0.034，0.034）。多因素分析提示：在CHOP组，IPI评分和Ki-67高表达均是独立的预后因素；在R-CHOP组，Ki-67高表达是唯一的独立预后因素。结论利妥昔单抗应用前后，Ki-67高表达均是DLBCL的不良预后因素。
目的：探討利妥昔單抗應用前後Ki-67錶達在瀰漫性大B細胞淋巴瘤(DLBCL)中的預後意義。方法收集廣東醫學院附屬醫院69例接受R-CHOP和50例接受CHOP治療的DLBCL患者的臨床資料，分析Ki-67錶達及其與DLBCL預後的關繫。結果119例患者中男：女比例為1.83∶1，平均(50.4±12.8)歲，Ki-67高錶達(≥85%)患者佔28.6%，多見于IPI 3～5分患者（P=0.039），與其他臨床特徵比較，差異無統計學意義。按治療方案將患者分為CHOP組和R-CHOP組，2組患者在性彆、年齡、B癥狀、LDH水平、ECOG、病理分期、結外纍及、IPI評分及Ki-67錶達方麵比較，差異無統計學意義，基線資料可比。單因素預後分析顯示，Ki-67高錶達在CHOP和R-CHOP組均提示不良的OS（P=0.002，0.004）和PFS（P=0.034，0.034）。多因素分析提示：在CHOP組，IPI評分和Ki-67高錶達均是獨立的預後因素；在R-CHOP組，Ki-67高錶達是唯一的獨立預後因素。結論利妥昔單抗應用前後，Ki-67高錶達均是DLBCL的不良預後因素。
목적：탐토리타석단항응용전후Ki-67표체재미만성대B세포림파류(DLBCL)중적예후의의。방법수집엄동의학원부속의원69례접수R-CHOP화50례접수CHOP치료적DLBCL환자적림상자료，분석Ki-67표체급기여DLBCL예후적관계。결과119례환자중남：녀비례위1.83∶1，평균(50.4±12.8)세，Ki-67고표체(≥85%)환자점28.6%，다견우IPI 3～5분환자（P=0.039），여기타림상특정비교，차이무통계학의의。안치료방안장환자분위CHOP조화R-CHOP조，2조환자재성별、년령、B증상、LDH수평、ECOG、병리분기、결외루급、IPI평분급Ki-67표체방면비교，차이무통계학의의，기선자료가비。단인소예후분석현시，Ki-67고표체재CHOP화R-CHOP조균제시불량적OS（P=0.002，0.004）화PFS（P=0.034，0.034）。다인소분석제시：재CHOP조，IPI평분화Ki-67고표체균시독립적예후인소；재R-CHOP조，Ki-67고표체시유일적독립예후인소。결론리타석단항응용전후，Ki-67고표체균시DLBCL적불량예후인소。
Objective To explore the expression and clinical significance of Ki-67 in patients with diffuse large B cell lymphoma (DLBCL) before and after the introduction of rituximab.Methods One hundred and nineteen patients with DLBCL were analyzed retrospectively. Among them, 69 received R-CHOP while 50 received CHOP with IPI-matched.Results Among the 119 patients, the ratio of male to female was 1.83∶1; the median age was 50 years. High expression of Ki-67 (≥85%) was detected in 28.6% of all patients. The high Ki-67 expression correlated with high IPI score (3-5) (P=0.039). No association was observed between Ki-67 expression and other clinical features, including age, gender, performance, stage, B symptoms, LDH level, and extranodal site. There were no differences among clinical features in the CHOP and R-CHOP group. In the both CHOP group and R-CHOP group,high Ki-67 expression implied poor overall survival (OS) (P=0.002,0.004) and progression-free survival (PFS) (P=0.034,0.034). In multivariate analysis of the CHOP group, both Ki-67 expression and IPI were significant prognostic factors for OS and PFS. In the R-CHOP group high Ki-67 expression was the only poor prognosticfactor for OS and PFS.Conclusion The high expression of Ki-67 associated with poor outcome in DLBCL patients before and after the introduction of rituximab.
