国际输血及血液学杂志
國際輸血及血液學雜誌
국제수혈급혈액학잡지
INTERNATIONAL JOURNAL OF BLOOD TRANSFUSION AND HEMATOLOGY
2014年
6期
507-511
,共5页
李蒲%李菲%陈艳%肖承京%张荣艳%杨赣萍%黄先豹%纪德香%胥茜
李蒲%李菲%陳豔%肖承京%張榮豔%楊贛萍%黃先豹%紀德香%胥茜
리포%리비%진염%초승경%장영염%양공평%황선표%기덕향%서천
淋巴瘤,大B细胞,弥漫性%巨噬细胞%淋巴瘤,非霍奇金
淋巴瘤,大B細胞,瀰漫性%巨噬細胞%淋巴瘤,非霍奇金
림파류,대B세포,미만성%거서세포%림파류,비곽기금
Lymphoma,large B-cell,diffuse%Macrophages%Lymphoma,non-Hodgkin
目的 探讨CD68+淋巴瘤相关巨噬细胞(LAM)在弥漫性大B细胞淋巴瘤(DLBCL)中的表达及其在肿瘤形成中的作用,明确其临床意义.方法 选择2011年10月至2013年4月南昌大学第一附属医院收治首诊为DLBCL的患者60例为研究对象,纳入研究组;选择同期于同一医院收治的首诊为淋巴结反应性增生的患者20例纳入对照组.采用免疫组化二步法检测两组患者CD68+ LAM表达数目,并对不同临床特征DLBCL患者的CD68+ LAM数目进行比较.本研究遵循的程序符合南昌大学第一附属医院人体试验委员会所制定的伦理学标准,得到该委员会批准,分组征得受试对象本人的知情同意,并与之签署临床研究知情同意书.两组患者的性别、年龄、Ann Arbor分期与有、无B症状者及疾病风险等级比较,差异无统计学意义(P＞0.05),两组患者具有可比性.结果 对不同年龄、不同Ann Arbor分期与有、无脊髓侵犯DLBCL患者的CD68+ LAM数目进行比较,差异均有统计学意义(F=2.946,3.798,2.214;P=0.024,0.009,0.043);不同性别、血清乳酸脱氢酶水平及有、无B症状与有、无巨大肿块DLBCL患者的CD68+ LAM数目比较,差异均无统计学意义(P＞0.05).不同国际预后指数(IPI)评分DLBCL患者的CD68+LAM数目与对照组比较,差异有统计学意义(F=26.522,P＜0.05);各IPI分级DLBCL患者的CD68+ LAM数目均显著高于对照组,且差异均有统计学意义(P＜0.05).本组60例DLBCL患者中,CD68-LAM高密度表达者为13例(21.7％),低密度表达者为47例(78.3％);CD68+ LAM高密度表达组治疗有效率为76.9％(10/13),低密度表达组治疗有效率为93.6％(44/47),二者比较,差异有统计学意义(Ridit z=12.152,P＜0.05).CD68+ LAM高密度表达组患者的中位生存时间为22.1个月,低密度表达组中位生存时间为40.1个月,二者比较,差异有统计学意义(P＜0.05).结论 CD68+ LAM在不同恶性程度和不同预后风险的DLBCL患者中表达不同,不同CD68+ LAM表达密度DLBCL患者的预后也不同.临床实践中可尝试将CD68+ LAM作为DLBCL预后的预测指标.
目的 探討CD68+淋巴瘤相關巨噬細胞(LAM)在瀰漫性大B細胞淋巴瘤(DLBCL)中的錶達及其在腫瘤形成中的作用,明確其臨床意義.方法 選擇2011年10月至2013年4月南昌大學第一附屬醫院收治首診為DLBCL的患者60例為研究對象,納入研究組;選擇同期于同一醫院收治的首診為淋巴結反應性增生的患者20例納入對照組.採用免疫組化二步法檢測兩組患者CD68+ LAM錶達數目,併對不同臨床特徵DLBCL患者的CD68+ LAM數目進行比較.本研究遵循的程序符閤南昌大學第一附屬醫院人體試驗委員會所製定的倫理學標準,得到該委員會批準,分組徵得受試對象本人的知情同意,併與之籤署臨床研究知情同意書.兩組患者的性彆、年齡、Ann Arbor分期與有、無B癥狀者及疾病風險等級比較,差異無統計學意義(P＞0.05),兩組患者具有可比性.結果 對不同年齡、不同Ann Arbor分期與有、無脊髓侵犯DLBCL患者的CD68+ LAM數目進行比較,差異均有統計學意義(F=2.946,3.798,2.214;P=0.024,0.009,0.043);不同性彆、血清乳痠脫氫酶水平及有、無B癥狀與有、無巨大腫塊DLBCL患者的CD68+ LAM數目比較,差異均無統計學意義(P＞0.05).不同國際預後指數(IPI)評分DLBCL患者的CD68+LAM數目與對照組比較,差異有統計學意義(F=26.522,P＜0.05);各IPI分級DLBCL患者的CD68+ LAM數目均顯著高于對照組,且差異均有統計學意義(P＜0.05).本組60例DLBCL患者中,CD68-LAM高密度錶達者為13例(21.7％),低密度錶達者為47例(78.3％);CD68+ LAM高密度錶達組治療有效率為76.9％(10/13),低密度錶達組治療有效率為93.6％(44/47),二者比較,差異有統計學意義(Ridit z=12.152,P＜0.05).CD68+ LAM高密度錶達組患者的中位生存時間為22.1箇月,低密度錶達組中位生存時間為40.1箇月,二者比較,差異有統計學意義(P＜0.05).結論 CD68+ LAM在不同噁性程度和不同預後風險的DLBCL患者中錶達不同,不同CD68+ LAM錶達密度DLBCL患者的預後也不同.臨床實踐中可嘗試將CD68+ LAM作為DLBCL預後的預測指標.
목적 탐토CD68+림파류상관거서세포(LAM)재미만성대B세포림파류(DLBCL)중적표체급기재종류형성중적작용,명학기림상의의.방법 선택2011년10월지2013년4월남창대학제일부속의원수치수진위DLBCL적환자60례위연구대상,납입연구조;선택동기우동일의원수치적수진위림파결반응성증생적환자20례납입대조조.채용면역조화이보법검측량조환자CD68+ LAM표체수목,병대불동림상특정DLBCL환자적CD68+ LAM수목진행비교.본연구준순적정서부합남창대학제일부속의원인체시험위원회소제정적윤리학표준,득도해위원회비준,분조정득수시대상본인적지정동의,병여지첨서림상연구지정동의서.량조환자적성별、년령、Ann Arbor분기여유、무B증상자급질병풍험등급비교,차이무통계학의의(P＞0.05),량조환자구유가비성.결과 대불동년령、불동Ann Arbor분기여유、무척수침범DLBCL환자적CD68+ LAM수목진행비교,차이균유통계학의의(F=2.946,3.798,2.214;P=0.024,0.009,0.043);불동성별、혈청유산탈경매수평급유、무B증상여유、무거대종괴DLBCL환자적CD68+ LAM수목비교,차이균무통계학의의(P＞0.05).불동국제예후지수(IPI)평분DLBCL환자적CD68+LAM수목여대조조비교,차이유통계학의의(F=26.522,P＜0.05);각IPI분급DLBCL환자적CD68+ LAM수목균현저고우대조조,차차이균유통계학의의(P＜0.05).본조60례DLBCL환자중,CD68-LAM고밀도표체자위13례(21.7％),저밀도표체자위47례(78.3％);CD68+ LAM고밀도표체조치료유효솔위76.9％(10/13),저밀도표체조치료유효솔위93.6％(44/47),이자비교,차이유통계학의의(Ridit z=12.152,P＜0.05).CD68+ LAM고밀도표체조환자적중위생존시간위22.1개월,저밀도표체조중위생존시간위40.1개월,이자비교,차이유통계학의의(P＜0.05).결론 CD68+ LAM재불동악성정도화불동예후풍험적DLBCL환자중표체불동,불동CD68+ LAM표체밀도DLBCL환자적예후야불동.림상실천중가상시장CD68+ LAM작위DLBCL예후적예측지표.
Objective To investigate the expression and clinical significance of CD68+ lymphoma associated macrophage (LAM) in diffuse large B-cell lymphoma (DLBCL).Methods From October 2011 to April 2013,a total of 60 cases with DLBCL who were first diagnosed in the First Affiliated Hospital of Nanchang University were collected into this study,as the study group.And 20 cased with lymph node reactive hyperplasia who were first diagnosed in the same hospital during the same period were included into the control group.The number of CD68+ LAM of study group and control group was detected by two-step immunohistochemical staining method,and compared the number of CD68+ LAM among DLBCL patients with different clinical features.The study protocol was approved by the Ethical Review Board of Investigation in Human Being of the First Affiliated Hospital of Nanchang University.Informed consent was obtained from all participants.There were no significant differences of patients' general clinical features between two groups (P＞ 0.05).Results The number of CD68+ LAM among DLBCL patients with different ages,different Ann Arbor stage,with and without spinal cord invasion was different from each other and the differences were all statistically significant (F=2.946,3.798,2.214; P=0.024,0.009,0.043).While there were no statistically significant differences among DLBCL patients with different ages,different serum lactic dehydrogenase levels,with or without B symptom and with or without megalo-lump (P＞0.05).The number of CD68+ LAM in DLBCL patients with different international prognostic index (IPI) scores compared with that in control group,the difference was statistically significant (F=26.522,P＜0.05); And the number of CD68+ LAM in each IPI level group was higher than control group (P＜0.05).Among the 60 cases with DLBCL,there were 13 cases (21.7％) with high-density expression of CD68+ LAM and 47 cases (78.3％) with low-density expression.The therapy efficiency of CD68+ LAM high-density expression group (10/13,76.9 ％) was lower than the low-density expression group (44/47,93.6％),and the difference was statistically significant (Ridit z =12.152,P＜0.05).The median survival time of CD68+ LAM high-density expression group was 22.1 months,while the low-density expression group was 40.1 months,the difference was statistically significant (P ＜ 0.05).Conclusions The expression of CD68+ LAM in DLBCL patients with different malignant degree and prognosis risk differ from each other.And prognosis of DLBCL patients with different expression of CD68+ LAM also differs from each other.Clinical practice may try to use CD68+ LAM as a prognostic indicator of DLBCL.
