CAJ | 학술논문

目的研究Fcγ受体Ⅲa(FcγRⅢa)基因多态性对接受含利妥昔单抗(RTX)的免疫化学治疗的弥漫大B细胞淋巴瘤(DLBCL)患者疗效及预后的影响.方法以接受8(4～12)个疗程含RTX的免疫化学治疗的122例DLBCL患者和100名健康正常人为研究对象,采用PCR联合测序法检测其FcγRⅢa基因型,并分析FcγRⅢa基因多态性与患者疗效和预后的关系.结果 122例患者中FcγRⅢa基因F/F型、V/V型及V/F型者分别为78例(63.93％)、5例(4.10％)和39例(31.97％),各基因型在DLBCL组和正常对照组的分布差异无统计学意义(P＞0.05);各基因型的分布与患者性别、年龄、分期、免疫分型、乳酸脱氢酶(LDH)水平及国际预后积分(IPI)等临床特征无明显相关性(P值均＞0.05);122例患者的完全缓解(CR)率为80.33％,部分缓解(PR)率为9.02％,总缓解率(ORR)为89.35％;F/F型、V/V型及V/F型患者的CR率分别为69.23％、100.00％、100.00％,PR率分别为14.10％、0、0,ORR分别为83.33％、100.00％、100.00％,V/V型及V/F型的CR率及ORR相近,明显优于F/F型(P值均＜0.05).中位随访时间为35(12～62)个月,122例患者中46例(37.70％)疾病进展或复发,40例(32.79％)死亡;3年无进展生存(PFS)及3年总生存(OS)率分别为62.29％和67.21％; F/F型、V/V型及V/F型患者的3年PFS率分别为41.03％、100.00％、100.00％,3年OS率分别为48.72％、100.00％、100.00％;经生存分析,V/V及V/F基因型的PFS及OS率相近,明显优于F/F型(P值均＜0.05).结论 FcγRⅢa基因多态性可以预测含RTX的免疫化疗对DLBCL患者的疗效及预后.
목적 연구Fcγ수체Ⅲa(FcγRⅢa)기인다태성대접수함리타석단항(RTX)적면역화학치료적미만대B세포림파류(DLBCL)환자료효급예후적영향.방법 이접수8(4～12)개료정함RTX적면역화학치료적122례DLBCL환자화100명건강정상인위연구대상,채용PCR연합측서법검측기FcγRⅢa기인형,병분석FcγRⅢa기인다태성여환자료효화예후적관계.결과 122례환자중FcγRⅢa기인F/F형、V/V형급V/F형자분별위78례(63.93％)、5례(4.10％)화39례(31.97％),각기인형재DLBCL조화정상대조조적분포차이무통계학의의(P＞0.05);각기인형적분포여환자성별、년령、분기、면역분형、유산탈경매(LDH)수평급국제예후적분(IPI)등림상특정무명현상관성(P치균＞0.05);122례환자적완전완해(CR)솔위80.33％,부분완해(PR)솔위9.02％,총완해솔(ORR)위89.35％;F/F형、V/V형급V/F형환자적CR솔분별위69.23％、100.00％、100.00％,PR솔분별위14.10％、0、0,ORR분별위83.33％、100.00％、100.00％,V/V형급V/F형적CR솔급ORR상근,명현우우F/F형(P치균＜0.05).중위수방시간위35(12～62)개월,122례환자중46례(37.70％)질병진전혹복발,40례(32.79％)사망;3년무진전생존(PFS)급3년총생존(OS)솔분별위62.29％화67.21％; F/F형、V/V형급V/F형환자적3년PFS솔분별위41.03％、100.00％、100.00％,3년OS솔분별위48.72％、100.00％、100.00％;경생존분석,V/V급V/F기인형적PFS급OS솔상근,명현우우F/F형(P치균＜0.05).결론 FcγRⅢa기인다태성가이예측함RTX적면역화료대DLBCL환자적료효급예후.
Objective To evaluate the impact of Fc gamma receptor Ⅲ a (FcγR Ⅲa) polymorphisms on the efficacy of rituximab (RTX) combined chemotherapy for patients with diffuse large B-cell lymphoma (DLBCL).Methods FcγR Ⅲa polymorphisms were analyzed by PCR in 122 patients and 100 healthy controls.All patients received 8 (4-12) cycles of RTX combined chemotherapy.Results 78 (63.93％) patients with F/F,5 (4.10％) with V/V,and 39 (31.97％) with V/F were identified,which were not different compared to controls.Patients with different FcγR Ⅲa genotypes did not have any difference in terms of gender,age,molecular subtypes,lactate dehydrogenase (LDH) or international prognostic index (IPI).The overall response rate (ORR) was 89.35％ with a complete response (CR) of 80.33％ and a partial response (PR) of 9.02％.The ORR was 83.33％,100.00％ and 100.00％ in F/F,V/V and V/F,respectively.A higher response rate was observed in V/V and V/F as compared with F/F (P＜0.05).With a median follow-up of 35 months (range:12-62 months),46 (37.71％) patients had relapsed and 40 (32.79％) cases progressed and ended in death.The 3-year progress-free survival (PFS) rate was 41.03％,100.00％,100.00％ in F/F,V/V and V/F,respectively.The 3-year overall survival (OS) rate was 48.72％,100.00％ and 100.00％ in patients with three genotypes.The PFS and OS rate were significantly higher in V/V and V/F as compared with F/F (P＜0.05).Conclusions Fcγ R Ⅲ a polymorphisms could predict response and prognosis of RTX combined chemotherapy for patients with DLBCL.