P53突变蛋白表达对弥漫大B细胞淋巴瘤预后的预测作用

 目的　探讨p53突变蛋白表达对弥漫大B细胞淋巴瘤（DLBCL）预后的预测作用,指导个体化治疗。方法　随机选择初治DLBCL患者62例,应用免疫组织化学方法检测p53突变蛋白和CD10、bcl-6、MUM1的表达,分析p53突变蛋白表达与患者临床特征、分子分型以及预后的关系。结果　48.4 %（30／62）的患者表达p53突变蛋白。p53突变蛋白表达与初始治疗反应有关（χ2＝20.365,P＝0.040）,阳性组的完全缓解率为33.3 %（10／30）,阴性组为59.4 %（19／21）;与分子分型有关（χ2＝31.023,P＝0.021）,阳性组非生发中心型比例显著高于阴性组,分别为83.3 %和56.2 %;与其他临床特征无关。多因素生存分析显示p53突变蛋白表达是独立的预后预测因子,阳性组的无进展生存期和中位生存期均短于阴性组（χ2＝36.784,P＝0.005和χ2＝35.276,P＝0.006）。结论　p53突变蛋白表达是DLBCL独立的不良预后因子,能够用来指导个体化治疗。     

弥漫性大Ｂ细胞淋巴瘤中Ｓｋｐ２和ｐ２７ｋｉｐ１的表达及其临床意义

目的　研究Ｓｋｐ２和ｐ２７^ｋｉｐ１蛋白在弥漫性大Ｂ细胞淋巴瘤（ＤＬＢＣＬ）中的表达及其相关性,探讨二者在ＤＬＢＣＬ发生发展中的作用及其临床意义。方法　免疫组化方法检测９６例ＤＬＢＣＬ石蜡样本中Ｓｋｐ２、ｐ２７^ｋｉｐ１的蛋白表达,并分析二者的相关性及其与ＤＬＢＣＬ临床特征之间的关系。结果　ＤＬＢＣＬ中Ｓｋｐ２阳性表达率为６０.４％,显著高于反应性增生淋巴组织中的２５.０％（Ｐ＜０.０５）;而ＤＬＢＣＬ中ｐ２７^ｋｉｐ１阳性表达率为２６.０％,显著低于反应性增生淋巴组织中的６５.０％（Ｐ＜０.０５）。ＤＬＢＣＬ中Ｓｋｐ２的阳性表达与ＡｎｎＡｒｂｏｒ分期、结外病灶数、Ｂ症状、ＬＤＨ水平有显著相关性（Ｐ＜０.０５）,与年龄、性别、ＰＳ评分无关（Ｐ＞０.０５）。其中Ⅲ ～Ⅳ期、结外病灶数≥２组Ｓｋｐ２表达阳性率分别为８２.４％和８０.０％,显著高于Ⅰ ～Ⅱ期、结外病灶数＜２组的４８.４％和５５.３％（Ｐ＜０.０５）;有Ｂ症状、ＬＤＨ水平升高组Ｓｋｐ２表达阳性率分别为８１.６％和６９.０％,显著高于无Ｂ症状、ＬＤＨ水平正常组的４６.６％和３６.０％（Ｐ＜０.０５）。ＤＬＢＣＬ中ｐ２７^ｋｉｐ１的阳性表达与ＡｎｎＡｒｂｏｒ分期、Ｂ症状、ＬＤＨ水平有显著相关性（Ｐ＜０.０５）,与年龄、性别、结外病灶数、ＰＳ评分无关（Ｐ＞０.０５）。其中Ⅲ ～Ⅳ期、有Ｂ症状、ＬＤＨ水平升高组ｐ２７^ｋｉｐ１的阳性表达率分别为１１.８％、１０.５％、１８.３％,显著低于Ⅰ ～Ⅱ期、无Ｂ症状、ＬＤＨ水平正常组的３３.９％、３６.２％、４８.０％（Ｐ＜０.０５）。ＤＬＢＣＬ中Ｓｋｐ２与ｐ２７^ｋｉｐ１表达无显著相关性（Ｐ＞０.０５）。结论　Ｓｋｐ２和ｐ２７^ｋｉｐ１在ＤＬＢＣＬ的发生发展过程中起一定的作用,Ｓｋｐ２和ｐ２７^ｋｉｐ１可作为判断ＤＬＢＣＬ预后有价值的指标,Ｓｋｐ２和ｐ２７^ｋｉｐ１在ＤＬＢＣＬ的发生发展过程中可能发挥着独立的作用。     

PIM1表达与弥漫大B细胞淋巴瘤患者预后的关系

背景与目的:Pim1是一种原癌基因,具有抑制肿瘤细胞凋亡、促进肿瘤细胞增殖的功能.本研究旨在探讨PIM1蛋白与原发性弥漫大B细胞淋巴瘤(diffuse large B-cell lymphoma,DLBCL)预后的关系.方法:采用免疫组化方法评估53例初治原发性DLBCL患者的PIM1表达,回顾性分析PIM1的表达与化疗反应性和总生存的关系.结果:PIM1蛋白高表达与DLBCL的负性预后相关,且它的表达与非生发中心的表型相关(r=0.404,P=0.003).PIM1蛋白高表达患者的3年总生存率和化疗完全缓解率均比低表达者低,差异有统计学意义(29.2%vs62.1%:29.2%vs 68.9%,P＜0.001和P=0.006).PIM1和国际预后指数(international prognostic index,IPI)的多因素分析表明,PIM1是总生存独立的预后因素(P=0.013).单因素Logistic回归分析表明,PIM1的表达与化疗的完全缓解率呈负相关.结论:在DLBCL患者中,PIM1的高表达可以作为一个临床预后不良标志.     

Prognostic impact of p53 aberrations for R-CHOP-treated patients with diffuse large B-cell lymphoma

Diffuse large B-cell lymphoma (DLBCL) is the most frequent lymphoma in adults. There are specific alterations that appear repeatedly in DLBCL cases and play a role in lymphomagenesis or progression of the disease. Some aberrations were used as prognostic markers in the pre-rituximab era. Addition of rituximab to the classical anthracycline-based chemotherapy significantly increased the survival rate in DLBCL. Only few prognostic factors have been re-evaluated for patients treated with R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone). We performed complex analysis of the p53 tumor suppressor in collection of 75 DLBCL cases. Fifty-four patients were de novo cases, twenty-one cases developed into DLBCL by transformation from less aggressive disease. We determined functional status by analysis of separated alleles in yeast (FASAY) and analyzed the p53 mutations by cDNA sequencing. We assessed the level of the p53 protein by immunoblot analysis. We used FISH to analyze loss of the p53 and ATM (ataxia telangiectasia mutated) gene deletions. We detected 16 p53 mutations (21.3%) including the mutation activating non-sense-mediated RNA decay pathway. Deletion of the p53 allele was more common in cases with p53 mutation. Mutations and/or deletions of p53 had statistically significant negative impact on progression-free survival and tended to decrease also overall survival in 46 de?novo DLBCL patients treated with R-CHOP. p53 aberrations are negative predictors for survival of DLBCL patients treated with R-CHOP.     

Prognostic impact of extranodal involvement in diffuse large B-cell lymphoma in the rituximab era

BACKGROUND:

Extranodal involvement is considered a poor prognostic factor for patients with diffuse large B‐cell lymphoma (DLBCL); however, the prognostic impact of specific sites of involvement has not been fully elucidated.

METHODS:

The authors retrospectively analyzed 1221 patients treated uniformly with standard R‐CHOP therapy between 2003 and 2006. Patients with distinct forms of DLBCL such as intravascular lymphoma, primary effusion lymphoma, pyothorax‐associated lymphoma, primary central nervous system lymphoma, and intraocular lymphoma were also excluded. The authors evaluated 26 extranodal sites of involvement with respect to prognostic impact. The median age was 64 years (range, 15‐91 years).

RESULTS:

Univariate analysis revealed that patients with involvement of specific extranodal sites had significantly worse overall survival (OS) than did patients without such involvement; these sites included nasal cavity, paranasal sinus, lung, pleura, small intestine, peritoneum, liver, pancreas, stomach, spleen, adrenal gland, testis, bone, bone marrow, peripheral blood, skin, and subcutaneous tissue. Patients with Waldeyer ring involvement had significantly better OS. Multivariate analysis revealed that patients with the involvement of the pleura (P < .001), small intestine (P = .015), peritoneum (P = .002), adrenal gland (P < .001), testis (P = .005), bone marrow (P < .001), and peripheral blood (P = .002) had significantly worse OS, whereas those with Waldeyer ring involvement had significantly better OS (P = .038). Subgroup analysis with the nodal and/or Waldeyer patient group also showed prognostic impact of Waldeyer ring by multivariate analysis (relative risk, 0.3; P = .04).

CONCLUSIONS:

Extranodal involvement affects the prognosis of patients undergoing R‐CHOP therapy for DLBCL. Cancer 2012. © 2011 American Cancer Society.     

Prognostic significance of p27/kip1 and apoptosis in patients with colorectal carcinoma

The protein p27/kip1 is a cyclin-dependent kinase inhibitor that regulates cell-cycle progression. In the present study, p27/kip1 expression as well as tumor cell proliferation and apoptosis were investigated in 80 colorectal carcinomas, using anti-p27/kip1 antibodies, in situ apoptosis detection kits and anti-PCNA antibodies. Immunohistochemical staining indicated that p27/kip1 was localized heterogeneously in the nuclei of cancer cells. The frequency of samples positive for p27/kip1 was 53.8% (43/80). There was no significant correlation between p27/kip1 status and clinicopathologic factors. Mean apoptotic index (AI) in p27/kip1-positive patients (3.22+/-1.65) was significantly higher than in p27/kip1-negative patients (2.46+/-1.44; p=0.033). No correlation was observed between p27/kip1 expression and the PCNA labeling index (PCNA-LI) (p=0.47). Overall survival was significantly longer for patients who were p27/kip1-positive (80.7%) compared to those who were negative (49.3%; p=0.0003). Univariate analysis revealed no significant differences between prognosis and AI or PCNA-LI. In multivariate analysis, p27/kip1 expression was found to be an independent prognostic marker (p=0.015). In conclusion, the present study shows that p27/kip1 is a potentially important prognostic and predictive marker for outcome in colorectal carcinoma. These results might be explained by the role of p27/kip1 in promoting apoptosis.     

Prognostic impact of immunohistochemical biomarkers in diffuse large B-cell lymphoma in the rituximab era

We evaluated the usefulness of prognostic markers in patients with diffuse large B-cell lymphoma (DLBCL) treated with cyclophosphamide, vincristine, doxorubicin, and prednisolone (CHOP) ± rituximab (R-CHOP) in Japan. We studied 730 patients with DLBCL; 451 received CHOP and 279 R-CHOP. We analyzed biopsy samples immunohistochemically for markers of germinal center B cells (CD10, Bcl-6), postgerminal center B cells (Multiple myeloma-1), and apoptosis (Bcl-2). The median follow-up period for surviving patients was 56.4 months for the CHOP group and 25.2 months for the R-CHOP group. DLBCL were categorized as germinal center B (GCB) subtype (352/730; 48.2%) or non-GCB subtype (378/730; 51.8%). In the CHOP group, the high expression of CD10 ( P  = 0.022) or Bcl-6 ( P  = 0.021), or GCB subtype ( P  = 0.05) was associated with better overall survival, whereas the high expression of Bcl-2 ( P  = 0.001) or MUM1 ( P  = 0.011), or non-GCB subtype ( P  = 0.05) was associated with worse overall survival. In the R-CHOP group, however, these biomarkers except Bcl-6 were not significant prognostic factors. The patients with non-GCB subtype showed improved survival in the R-CHOP group ( P  = 0.756). The International Prognostic Index was a useful clinical marker of survival in the CHOP group ( P  < 0.001) and also in the R-CHOP group ( P  < 0.001). Results of improved survival with rituximab addition indicate that the relevance of previously recognized prognostic factors should be re-evaluated. ( Cancer Sci  2009; 100: 1842–1847)     

Prognostic models for diffuse large B-cell lymphoma in the rituximab era: a never-ending story

BackgroundImproved treatment have modified survival outcome in patients with diffuse large B-cell lymphoma (DLBCL) and altered the importance of previously recognized prognostic markers.Design and methodsTo evaluate International Prognostic Index (IPI) score before and after rituximab introduction and to validate the absolute lymphocyte count (ALC)/revised International Prognostic Index (R-IPI) model, we carried out a retrospective analysis on a total of 831 patients with DLBCL.ResultsOur results show that IPI lost its discriminating power with the introduction of rituximab. The analysis of our second set allowed us to validate the ALC/R-IPI model. The R-IPI and ALC/R-IPI could still be used for designing clinical trials, but both have difficulty recognizing a high percentage of poor prognosis patients, though it remains an important goal of a good prognostic model considering the modest impact of salvage treatments on survival.ConclusionsA new model on the basis of significant variables in the rituximab era and built on a large database of patients treated with rituximab is urgently needed. As prognostic models are changing with the efficacy and mechanisms of action of treatment utilized, looking for a new prognostic score is a never-ending story in which researchers are trying to hit a continuously moving target.     

Prognostic significance of clonal diversity of immunoglobulin gene rearrangements in patients with diffuse large B-cell lymphoma

Clonal diversity of the immunoglobulin (Ig) gene rearrangement represents the oligoclonality of B-cell neoplasm, and has been shown to be a marker for poor prognosis in acute lymphoblastic leukemia. However, no previous report has addressed its prognostic impact in diffuse large B-cell lymphoma (DLBCL). We investigated the clinical significance of clonal diversity in DLBCL patients. Lymph node samples from 98 DLBCL patients were examined for Ig heavy and light chain gene rearrangements using Southern blot analysis. Clonal diversity was defined as oligoclonality detected on Southern blotting as previously described, and PCR analysis for IgH oligoclonality was performed on parts of DLBCL samples with clonal diversity for confirming the Southern blot analysis results. We found that clonal diversity could be detected in 36 (36.7%) of DLBCL patients, and PCR analysis showed concordant results. Regarding the clinical relevance, clonal diversity was significantly associated with relapse or refractory disease. Survival analysis showed that clonal diversity is an independent prognostic factor in DLBCL (p=0.05, Cox's proportional hazard method), and stratified analyses found the most significant subgroup is the high-intermediate risk category (p=0.01, log-rank test). We conclude that clonal diversity of Ig gene rearrangements is associated with a high risk of relapse or refractory disease in DLBCL patients. It is also a factor of poor prognosis in DLBCL, especially for high-intermediate risk category.     

Prognostic significance of p27(kip1) protein expression and spontaneous apoptosis in patients with colorectal adenocarcinomas

Tumor cell apoptosis, proliferation and p27 expression using an in situ apoptosis detection kit, anti-Ki67 antibody and anti-p27 antibody were investigated in 171 colorectal adenocarcinoma specimens, together with the assessment of mutated p53 expression. No apparent association was observed among p27 expression, mutated p53 accumulation, the Ki67 labeling index and the apoptotic index (AI). In the multivariate analysis using the median values as the cut-off points (46.8% for p27 expression and 0.89% for AI), p27 expression was identified as an independent and significant predictor for overall survival. When the present series of patients were dichotomized by these cut-off points to categorize the cases into 4 subgroups, the patients in the group with low p27 expression and a low AI had the poorest prognosis. The assessment of p27 expression and AI therefore may prove valuable in identifying patients with colorectal adenocarcinoma who may have a poor prognosis.     

18F-FDG PET-CT在弥漫大B细胞淋巴瘤预后判断中的价值

目的 探讨18F-FDG PET-CT在弥漫大B细胞淋巴瘤(DLBCL)预后判断中的价值.方法 回顾性分析2009年6月至2015年5月130例初诊DLBCL患者的临床资料及治疗前18F-FDG PET-CT检查结果.结果130例DLBCL患者18F-FDG PET-CT检查的最大标准摄取值(SUVmax)、病灶代谢体积(MTV)及病灶糖酵解总量(TLG)的中位数分别为19.93、34.45cm3、459.92.单因素分析结果显示:美国东部肿瘤协作组(ECOG)评分、AnnArbor分期、β2微球蛋白水平、乳酸脱氢酶水平、肿瘤直径、骨髓侵犯、改良国际预后指数(NCCN-IPI)评分、MTV、TLG均是患者无进展生存(PFS)率及总生存(OS)率的影响因素(均P<0.05);年龄是患者PFS率的影响因素(P<0.05).由于MTV与TLG高度相关,多因素分析时,二者中仅纳入TLG,结果显示:ECOG评分、Ann Arbor分期、NCCN-IPI评分及TLG是影响患者PFS率的独立因素(均P<0.05);NCCN-IPI评分及TLG是影响患者OS率的独立因素(均P<0.05).根据NCCN-IPI评分和TLG将患者分为低危组、中危组和高危组.低、中、高危组患者3年PFS率分别为66.0%、36.8%、26.1%,3年OS率分别为70.0%、49.1%、39.1%,差异均有统计学意义(均P<0.05).结论18F-FDG PET-CT所测得的TLG是影响DLBCL患者PFS及OS的独立预后因素,对DLBCL患者预后判断具有一定的参考价值.     

Prognostic significance of Ki-67 nuclear proliferative antigen, bcl-2 protein, and p53 expression in follicular and diffuse large B-cell lymphoma

We analyzed 104 patients with non-Hodgkin’s lymphoma, follicular or diffuse large-B-cell-type lymphoma, in order to evaluate the correlation between clinical characteristics and immunohistochemical parameters. Immunostaining was performed by means of monoclonal antibodies against Ki-67, bcl-2, and p53 expression. Forty-nine of the patients showed follicular lymphoma. A high expression of bcl-2 was found in 93%, high expression of p53 in 57%, and low expression of Ki-67 in 96%. Follicular lymphoma grade III showed a p53 expression (p=0.07) slightly higher than follicular lymphoma grades I and II, not reaching statistical significance. Follicular lymphoma grades I and II tended to express lower Ki-67 and higher levels of bcl-2 expression than grade III (p=0.06). Fifty-five cases showed diffuse large-B-cell lymphoma. Among them, bcl-2 was absent in 39%, whereas p53 and Ki-67 expression were high in 38%. In the diffuse large-B-cell lymphomas, a high bcl-2 expression correlated with stages III and IV (p=0.03) and involvement of more than one extranodal area (p=0.03). High Ki-67 expression was also associated to extranodal involvement of more than one area (p=0.03). Overall survival of patients did not show statistically significant differences regarding Ki-67, bcl-2, and p53 tumoral expression. Prognostic factors for overall survival in the multivariate analysis were age (p=0.02) and LDH (p=0.003). Time to progression was worse among follicular lymphoma with high p53 expression than with mild/moderate p53 expression (p=0.009).     

Statin-independent prognosis of patients with diffuse large B-cell lymphoma receiving rituximab plus CHOP therapy

BackgroundA recent laboratory study indicated that statins impaired the antitumor effects of rituximab by inducing conformational changes in CD20. Although these findings raised significant concerns about statin use during rituximab treatment, their clinical significance is unclear.Patients and methodsWe conducted a retrospective study investigating the effects of statins on the prognosis of diffuse large B-cell lymphoma (DLBCL) treated with rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (RCHOP). Newly diagnosed DLBCL patients were analyzed (n = 256), including 35 patients taking statins.ResultsThe 3-year progression-free survival rates were 84% and 73% (P = 0.38), while the overall survival rates were 89% and 78% (P = 0.28) for those patients treated with and without statins, respectively. After adjusting for the International Prognostic Index and serum cholesterol level, statin use was not associated with prognosis.ConclusionsThese results indicate that statins do not influence the clinical prognosis of DLBCL treated with RCHOP. Further studies with larger numbers of patients are warranted to confirm the prognostic significance of statins for patients with DLBCL receiving rituximab-containing chemotherapy.     

Central nervous system event in patients with diffuse large B-cell lymphoma in the rituximab era

Central nervous system (CNS) events, including CNS relapse and progression to CNS, are known to be serious complications in the clinical course of patients with lymphoma. This study aimed to evaluate the risk of CNS events in patients with diffuse large B-cell lymphoma in the rituximab era. We performed a retrospective survey of Japanese patients diagnosed with diffuse large B-cell lymphoma who underwent primary therapy with R-CHOP chemoimmunotherapy between September 2003 and December 2006. Patients who had received any prophylactic CNS treatment were excluded. Clinical data from 1221 patients were collected from 47 institutions. The median age of patients was 64 years (range, 15-91 years). We noted 82 CNS events (6.7%) and the cumulative 5-year probability of CNS events was 8.4%. Patients with a CNS event demonstrated significantly worse overall survival (P < 0.001). The 2-year overall survival rate after a CNS event was 27.1%. In a multivariate analysis, involvement of breast (relative risk [RR] 10.5), adrenal gland (RR 4.6) and bone (RR 2.0) were identified as independent risk factors for CNS events. We conclude that patients with these risk factors, in addition to patients with testicular involvement in whom CNS prophylaxis has been already justified, are at high risk for CNS events in the rituximab era. The efficacy and manner of CNS prophylaxis in patients for each involvement site should be evaluated further.     

弥漫性大B细胞淋巴瘤中MYC／BCL2蛋白共表达及其意义分析

目的：探讨245例弥漫性大B细胞淋巴瘤（DLBCL）中MYC/BCL2蛋白共表达状况及其与生发中心细胞样（GCB）及non-GCB亚型是否存在相关性。方法使用免疫组织化学方法对DLBCL石蜡标本制作的组织芯片进行MYC、BCL2、CD10、BCL6、MUM1、KI67检测,并对蛋白表达状况进行统计分析。结果245例DLBCL标本中,non-GCB患者163例（66．5％）,GCB患者82例（33．5％）,MYC和BCL2双阳性患者88例,占患者总数的35．9％（88/245）,占non-GCB病例的41．7％（68/163）,占GCB病例的24．4％（20/82）,在这两种亚型表达的差异具有统计学意义（χ2＝7．116,P＝0．008）。结论DLBCL中MYC/BCL2蛋白共表达在non-GCB亚型比GCB亚型更多,可以按照MYC/BCL2的共表达情况,把DLBCL分成不同亚群以区别治疗和判断预后。     

D-二聚体水平在初诊弥漫大B细胞淋巴瘤患者预后评估中的价值

目的探讨D-二聚体水平在弥漫大B细胞淋巴瘤(DLBCL)患者中的预后意义。方法回顾性分析2015年1月至2019年6月天津市人民医院收治的70例初诊DLBCL患者的临床资料,根据受试者工作特征(ROC)曲线确定D-二聚体判断患者生存的最佳截断值,并将患者分组。比较不同D-二聚体水平患者间凝血相关指标及临床病理特征差异;采用Kaplan-Meier法对总生存(OS)进行单因素分析,采用Cox回归模型进行OS多因素分析。结果根据ROC曲线,D-二聚体判断患者生存的最佳截断值为0.75 mg/L。D-二聚体≥0.75 mg/L组(36例)和<0.75 mg/L组(34例)中不同临床分期、国际预后指数评分、乳酸脱氢酶水平的患者比例比较,差异均有统计学意义(均P<0.05);血浆凝血酶原时间分别为(13.5±0.9)s和(13.0±0.8)s,活化部分凝血活酶时间分别为(37±5)s和(34±6)s,差异均有统计学意义(均P<0.05)。单因素生存分析显示,Ann Arbor分期Ⅲ~Ⅳ期、国际预后指数评分>2分、乳酸脱氢酶水平>240 U/L、有B症状、D-二聚体水平≥0.75 mg/L DLBCL患者5年OS率均降低(均P<0.05)。多因素Cox回归分析显示,D-二聚体≥0.75 mg/L为DLBCL患者OS独立危险因素(HR=0.368,95%CI 0.144~0.944,P=0.038)。结论D-二聚体水平可作为判断DLBCL患者预后的临床指标,D-二聚体水平高患者预后不良。     

弥漫大B细胞淋巴瘤survivin和p63表达的临床意义

 目的　探讨p63和survivin在弥漫大B细胞淋巴瘤（DLBCL）中的表达及临床意义。方法　采用免疫组织化学染色法检测p63蛋白和survivin蛋白在52例DLBCL和10例反应性增生淋巴结石蜡标本中的表达。结果　p63、survivin在DLBCL中表达阳性率分别为63.5 %（33例）和76.9 %（40例）,p63在反应性增生淋巴结中呈阴性表达,survivin在反应性增生淋巴结中阳性率为20.0 %（2例）,p63和survivin的表达率在两组之间差异有统计学意义。p63、survivin阳性组患者复发率分别为68.0 %和71.4 %,高于阴性组的22.2 %和30.8 %。p63、survivin阳性组患者平均生存期分别为18.5个月和17.5个月,低于阴性组的29.0个月和30.3个月。结论　p63和survivin可作为DLBCL的疗效和预后指标,可在早期筛选出常规治疗预后不良的病例,有助于指导临床治疗,改善预后。     

叉头框转录蛋白1在弥漫性大B细胞淋巴瘤中的表达及预后意义

目的 探讨叉头框转录蛋白1（FOXP1）在弥漫性大B细胞淋巴瘤（DLBCL）中的表达及其与DLBCL临床病理特征和预后的关系。方法 用免疫组织化学En Vision法检测85例DLBCL组织中FOXP1蛋白的表达情况,并分析FOXP1与临床病理特征及预后的关系。结果 85例DLBCL组织中FOXP1的阳性表达率为71.8％（61／85）,FOXP1表达与年龄、PS评分、乳酸脱氢酶（LDH）水平、国际预后指数评分、病理类型密切相关（P＜0.05）。在生发中心型（GCB）DLBCL中FOXP1阳性和阴性表达者的无病生存期（PFS）为13个月和44个月（P=0.002）,总生存期（OS）为28个月和50个月（P=0.003）;而在非生发中心型（non-GCB）中FOXP1表达与生存预后无关（P＞0.05）。单因素分析显示分期、LDH水平、有无B症状以及FOXP1表达与DLBCL患者的PFS和OS均相关（P＜0.05）,Cox多因素回归分析显示分期（95%CI：1.410~4.415,P=0.02）和FOXP1表达（95%CI：0.143～0.734,P=0.007）是PFS的独立预测因素。 结论 FOXP1蛋白有可能是DLBCL的一个重要的预后指标,尤其在GCB型DLBCL中FOXP1蛋白阳性表达提示预后不佳。