中华病理学杂志
中華病理學雜誌
중화병이학잡지
Chinese Journal of Pathology
2012年
12期
818-822
,共5页
姚伟凯%王银萍%彭芳%郑彦%邹亚斌%高静娜%刘雪力
姚偉凱%王銀萍%彭芳%鄭彥%鄒亞斌%高靜娜%劉雪力
요위개%왕은평%팽방%정언%추아빈%고정나%류설력
淋巴瘤,非霍奇金%淋巴瘤,大B-细胞,弥漫性%预后
淋巴瘤,非霍奇金%淋巴瘤,大B-細胞,瀰漫性%預後
림파류,비곽기금%림파류,대B-세포,미만성%예후
Lymphoma,non-Hodgkin%Lymphoma,large B-cell,diffuse%Prognosis
目的 观察CD21在弥漫性大B细胞淋巴瘤(DLBCL)中的表达,并探讨其与各种临床病理因素及预后的关系.方法 回顾性分析2005年6月至2011年9月吉林大学第一医院诊断明确、病例资料齐全的DLBCL患者的石蜡标本共80例,并且已经应用免疫组织化学(SP法)染色检测了肿瘤组织中 Ki-67、CD20、CD79a、CD3、CD43、CD5、cyclin D1 、bcl-2、CD10、bcl-6、GCET-1、FOXP-1和MUM-1蛋白表达情况.同时检测肿瘤组织中CD21的表达情况.分析CD21的表达情况与各临床因素的关系,各临床因素及CD21与总生存期的关系.结果 年龄≤60岁CD21+患者比例(64.0％,16/25)显著高于 CD21-患者(38.2％,21/55);临床分期为Ⅰ～Ⅱ期CD21+患者的比例(52.0％,13/25)显著高于CD21-患者(23.6％,13/55);结外受累数＜2个CD21+患者比例(68.0％,17/25)显著高于CD21-患者(41.8％,23/55);国际预后指数(IPI)评分为0～2时CD21+患者的比例(68.0％,17/25)显著高于CD21-患者(41.8％,23/55)；CD21+患者为GCB分型的比例(60.0％,15/25)显著高于CD21-患者(23.6％,13/55);CD21+患者因DLBCL导致死亡的比例(32.0％,8/25)显著低于CD21-患者(56.4％,31/55).单因素生存分析显示影响DLBCL患者总生存期的临床病理因素中,年龄、ECOG评分、乳酸脱氢酶(LDH)值、结外受累数、IPI评分、CD21的表达情况、治疗方案和疗效与预后密切相关,差异有统计学意义(P＜0.05).Cox模型多因素分析显示,ECOG评分、LDH值、结外受累数、CD21的表达情况等因素与预后密切相关,差异有统计学意义(P＜0.05).80例患者中CD21+患者的总生存期显著高于CD21-患者(P＜0.01).结论 CD21+的DLBCL患者有发病年龄低,临床分期早,节外受累数少以及IPI评分小的特点.CD21+的DLBCL患者的总生存期及中位生存期均显著高于CD21-患者.CD21的表达情况、ECOG评分、LDH值、结外受累数等因素是DLBCL患者的独立预后因素,CD21的阳性表达对DLBCL患者的预后更有意义.
目的 觀察CD21在瀰漫性大B細胞淋巴瘤(DLBCL)中的錶達,併探討其與各種臨床病理因素及預後的關繫.方法 迴顧性分析2005年6月至2011年9月吉林大學第一醫院診斷明確、病例資料齊全的DLBCL患者的石蠟標本共80例,併且已經應用免疫組織化學(SP法)染色檢測瞭腫瘤組織中 Ki-67、CD20、CD79a、CD3、CD43、CD5、cyclin D1 、bcl-2、CD10、bcl-6、GCET-1、FOXP-1和MUM-1蛋白錶達情況.同時檢測腫瘤組織中CD21的錶達情況.分析CD21的錶達情況與各臨床因素的關繫,各臨床因素及CD21與總生存期的關繫.結果 年齡≤60歲CD21+患者比例(64.0％,16/25)顯著高于 CD21-患者(38.2％,21/55);臨床分期為Ⅰ～Ⅱ期CD21+患者的比例(52.0％,13/25)顯著高于CD21-患者(23.6％,13/55);結外受纍數＜2箇CD21+患者比例(68.0％,17/25)顯著高于CD21-患者(41.8％,23/55);國際預後指數(IPI)評分為0～2時CD21+患者的比例(68.0％,17/25)顯著高于CD21-患者(41.8％,23/55)；CD21+患者為GCB分型的比例(60.0％,15/25)顯著高于CD21-患者(23.6％,13/55);CD21+患者因DLBCL導緻死亡的比例(32.0％,8/25)顯著低于CD21-患者(56.4％,31/55).單因素生存分析顯示影響DLBCL患者總生存期的臨床病理因素中,年齡、ECOG評分、乳痠脫氫酶(LDH)值、結外受纍數、IPI評分、CD21的錶達情況、治療方案和療效與預後密切相關,差異有統計學意義(P＜0.05).Cox模型多因素分析顯示,ECOG評分、LDH值、結外受纍數、CD21的錶達情況等因素與預後密切相關,差異有統計學意義(P＜0.05).80例患者中CD21+患者的總生存期顯著高于CD21-患者(P＜0.01).結論 CD21+的DLBCL患者有髮病年齡低,臨床分期早,節外受纍數少以及IPI評分小的特點.CD21+的DLBCL患者的總生存期及中位生存期均顯著高于CD21-患者.CD21的錶達情況、ECOG評分、LDH值、結外受纍數等因素是DLBCL患者的獨立預後因素,CD21的暘性錶達對DLBCL患者的預後更有意義.
목적 관찰CD21재미만성대B세포림파류(DLBCL)중적표체,병탐토기여각충림상병리인소급예후적관계.방법 회고성분석2005년6월지2011년9월길림대학제일의원진단명학、병례자료제전적DLBCL환자적석사표본공80례,병차이경응용면역조직화학(SP법)염색검측료종류조직중 Ki-67、CD20、CD79a、CD3、CD43、CD5、cyclin D1 、bcl-2、CD10、bcl-6、GCET-1、FOXP-1화MUM-1단백표체정황.동시검측종류조직중CD21적표체정황.분석CD21적표체정황여각림상인소적관계,각림상인소급CD21여총생존기적관계.결과 년령≤60세CD21+환자비례(64.0％,16/25)현저고우 CD21-환자(38.2％,21/55);림상분기위Ⅰ～Ⅱ기CD21+환자적비례(52.0％,13/25)현저고우CD21-환자(23.6％,13/55);결외수루수＜2개CD21+환자비례(68.0％,17/25)현저고우CD21-환자(41.8％,23/55);국제예후지수(IPI)평분위0～2시CD21+환자적비례(68.0％,17/25)현저고우CD21-환자(41.8％,23/55)；CD21+환자위GCB분형적비례(60.0％,15/25)현저고우CD21-환자(23.6％,13/55);CD21+환자인DLBCL도치사망적비례(32.0％,8/25)현저저우CD21-환자(56.4％,31/55).단인소생존분석현시영향DLBCL환자총생존기적림상병리인소중,년령、ECOG평분、유산탈경매(LDH)치、결외수루수、IPI평분、CD21적표체정황、치료방안화료효여예후밀절상관,차이유통계학의의(P＜0.05).Cox모형다인소분석현시,ECOG평분、LDH치、결외수루수、CD21적표체정황등인소여예후밀절상관,차이유통계학의의(P＜0.05).80례환자중CD21+환자적총생존기현저고우CD21-환자(P＜0.01).결론 CD21+적DLBCL환자유발병년령저,림상분기조,절외수루수소이급IPI평분소적특점.CD21+적DLBCL환자적총생존기급중위생존기균현저고우CD21-환자.CD21적표체정황、ECOG평분、LDH치、결외수루수등인소시DLBCL환자적독립예후인소,CD21적양성표체대DLBCL환자적예후경유의의.
Objective To analyze CD21 expression in diffuse large B cell lymphoma (DLBCL) and to explore its relationship with the clinicopathological characteristics and prognosis.Methods The clinical data from 80 DLBCL patients who were treated in First Hospital of Jilin University from June 2005 to September 2011 were retrospectively analyzed.The cases were subjected to immunohistochemical staining (SP method) for Ki-67,CD20,CD79a,CD3,CD43,CD5,cyclin D1,bcl-2,CD10,bcl-6,GCET-1,FOXP-1 and MUM-1 protein expression in the tumor tissue.Immunohistochemistry was also used to detect CD21 expression in the tumor tissue.SPSS 18.0 was used to analyze the relationship between CD21 expression and various clinical factors,and the relationship between various clinical factors including CD21 and overall survival.Results In the patients aged under 60 years,the incidence of CD21+ lymphoma (64.0％,16/25) was significantly higher than that of CD21+ lymphoma (38.2％,21/55).There were more CD21+ lymphoma patients who were at clinical stages Ⅰ-Ⅱ (52.0％,13/25)than patients with CD21 lymphomas (23.6％,13/55).There were also more CD21 + lymphoma patients (68.0％,17/25) having less than two extranodal sites involvement than CD21-lymphoma patients (41.8％,23/55).In addition,there were more CD21 + lymphoma patients with IPI 0-2 (68.0％,17/25) than CD21-lymphoma patients (41.8％,23/55).There were more CD21 + lymphoma patients with GCB subtype (60.0％,15/25) than CD21-lymphoma patients (23.6％,13/55).Death related to DLBCL was less in CD21 + lymphoma patients (32.0％,8/25) than CD21-lymphoma patients (56.4％,31/55).Univariate analysis showed that these clinical pathological characteristics affected the overall survival of DLBCL patients,including age,ECOG score,LDH,extranodal involvement,IPI index,CD21 expression,treatment option and efficacy (P ＜0.05).Cox multivariate analysis showed that ECOG score,LDH,extranodal involvement,CD21 expression were closely related to prognosis,and the difference was statistically significant (P ＜ 0.05).Among the 80 patients,the overall survival (OS) of CD21 + lymphoma patients was significantly higher than that of CD21-lymphoma patients.Conclusions The expression of CD21 is associated with young age at onset,early clinical stage,small number of involvement and low IPI index.The OS and median overall survival of CD21 + lymphoma patients are significantly higher than those of CD21-patients.CD21 expression,ECOG score,LDH,extranodal involvement are independent prognostic factors in DLBCL,and in particular,the expression of CD21 is more significant in the prognosis of DLBCL patients.
