弥漫性大B细胞淋巴瘤的分型与预后的研究进展

弥漫性大B细胞淋巴瘤(diffuse large B cell lymphoma,DLBCL)是一组在形态学、遗传学和临床表现上都具有异质性的肿瘤,是非霍奇金淋巴瘤中最常见的类型,在西方国家约占30%～40%,而在发展中国家比例还要高些[1]。这类肿瘤发生于淋巴结内或结外任何部位,可为原发或由其它低度恶性淋巴瘤转化而来。化学治疗通常能改善DLBCL患者的生存预后,     

胃肠道原发性弥漫性大B细胞淋巴瘤的分型研究

目的探讨胃肠道原发性弥漫性大B细胞淋巴瘤（DLBCL）的分型及与临床病理的关系。方法采用EnVision免疫组化法标记28例胃肠道原发性弥漫性大B细胞淋巴瘤中MUM1、bcl-6、CD10、bcl-2、Ki-67的表达。结果28例胃肠道原发性弥漫性大B细胞淋巴瘤中,12例为生发中心细胞样型（GCB）,16例为非生发中心细胞样型（非GCB）。非GCB型的增殖活性与GCB型相似;GCB型和非GCB型中bcl-2表达的阳性率分别为33.3%（4/12）和56.2%（9/16）。结论胃肠道原发性弥漫性大B细胞淋巴瘤以非GCB型多见,预后较差。     

弥漫性大B细胞淋巴瘤的临床病理研究进展

弥漫性大B细胞淋N（diffuselargeBcelllymphoma,DLBCL）是最常见的淋巴造血系统肿瘤。由于DLBCL表现出明显的异质性,所以对于它确切的分子机制还不是十分清楚。本文将对DLBCL的临床病理特点进行综述。     

输尿管弥漫性大B细胞淋巴瘤1例

患者男性，58岁。因双侧腰部不适在外院以左肾纤维化、左肾固缩行左肾切除术。术后1个多月出现全身浮肿，于当地医院行右输尿管双“J”管引流术，术后恢复良好，予以拔管，但拔管后半天即出现腹部胀痛、无尿。输尿管镜检查发现“右输尿管息肉”而再次入院，病程中未出现血尿。查体：急性痛苦病容，全身浅表淋巴结无肿大，胸骨无压痛，肝、脾肋下未及，双肾区无隆起，肾未扪及，输尿管无压痛，肾区无叩痛。     

弥漫性大B细胞淋巴瘤病理生物学研究进展

弥漫性大B细胞淋巴瘤（diffuse large B cell lymphoma，DLBCL）是目前最常见的成人非霍奇金淋巴瘤，无论在国外还是国内均为首位类型，占西方国家成人非霍奇金淋巴瘤构成比的30％～40％，发展中国家高达60％，儿童所占的比例在10％以下。DLBCL是一种具有侵袭性、生长迅速并具有显著临床异质性的中度～高度恶性淋巴瘤。近年来，国外对DLBCL病理学、分子生物学等方面有很多深入的研究并取得较多进展，但国内研究较少，现将DLBCL在病理生物学上进展结合国内外文献简要作一综述。     

滤泡性淋巴瘤转变为弥漫性大B细胞淋巴瘤1例

<正>患者女性,38岁。左颈部、双侧腹股沟淋巴结肿大1个月,超声检查最大3cm×2.5cm×2cm,最小1.5cm×1cm×0.5cm。在当地医院切除右侧腹股沟淋巴结活检,复查诊断为滤泡性淋巴瘤(滤泡型,2级)。采用COP方案化疗4个疗程后,淋巴结缩小出院。同年因左颈部、双侧腹股沟及双侧腋     

皮肌炎伴弥漫性大B细胞淋巴瘤一例

皮肌炎是一种自身免疫性疾病,可累及全身多个器官,并且可伴发恶性肿瘤。弥漫性大B细胞淋巴瘤(DLBCL)是非霍奇金淋巴瘤中最常见的一种类型,其临床表现和病理类型复杂多样,其中40%的患者可有结外表现。皮肌炎伴发DLBCL的报道少见,该例可为临床诊治提供更多思路。     

前尿道原发性弥漫性大B细胞淋巴瘤1例

患者男性,44岁.因无明显诱因出现尿频、尿线变细、排尿困难伴恶心4月余而入院行膀胱尿道镜检查,查体全身浅表淋巴结未触及.既往有前列腺增生及慢性膀胱炎病史.取F24膀胱尿道镜直视下进入尿道,可见尿道黏膜水肿,充血明显,部分有糜烂、坏死并出血,尿道变窄,考虑尿道急性炎症,取组织送检.     

3种方案治疗弥漫性大B细胞淋巴瘤疗效观察

目的:比较CHOP、CHOEP和RCHOP 3种化疗方案治疗弥漫性大B细胞淋巴瘤的疗效。方法:初治弥漫性大B细胞淋巴瘤患者25例依据化疗方案分为CHOP组7例、CHOEP组8例、RCHOP 10例,比较3组患者3年和5年生存率。结果:CHOEP组、RCHOP组3年及5年生存率均优于CHOP组(P<0.05);RCHOP组与CHOEP组3年及5年生存率比较差异无统计学意义(P>0.05)。结论:CHOEP和RCHOP方案治疗弥漫性大B细胞淋巴瘤其疗效优于CHOP方案。     

肾上腺弥漫性大B细胞淋巴瘤声像图特点分析

目的探讨肾上腺弥漫性大B细胞淋巴瘤(ADBCL)的超声声像图特点。方法回顾性分析经病理证实的18例ADBCL患者的超声表现及临床资料,总结其声像图特点,并与增强CT结果对照。结果本组18例ADBCL患者中,单侧4例,双侧14例,共32个病灶。肿块最大直径3.7~13.8 cm,平均7.9 cm。所有病灶均表现为低回声实质性肿块,81.3%(26/32)肿块形态不规则、呈典型的分叶状;87.5%(28/32)肿块内部回声均匀;75%(24/32)肿块边界清晰,部分有包膜;所有病灶彩色多普勒检查均未见明显血流信号。增强CT肿块显示为软组织密度影,内未见明显强化或轻度强化。结论 ADBCL具有特征性的声像图表现,超声检查对其诊断有重要价值。     

原发中枢神经系统的弥漫大B细胞淋巴瘤病理学诊断特征

目的探讨原发中枢神经系统的弥漫大B细胞淋巴瘤的病理学诊断特征。 方法回顾性分析2010年1月至2015年12月经泰安市中心医院病理科确诊的15例原发中枢神经系统的弥漫大B细胞淋巴瘤患者的临床资料,总结原发中枢神经系统的弥漫大B细胞淋巴瘤的病理形态学特点及免疫表型。 结果患者男性10例,女性5例,年龄52～64岁;15例患者临床表现为头痛头晕,反应迟钝或行走不稳。CT检查均发现颅内占位,4例发生了转移,分别转移到睾丸、肝脏、肺脏和乳腺,其余患者正电子发射计算机断层显像(PET-CT)检查均未见全身其他部位肿瘤。光镜下肿瘤细胞表现为弥漫性生长,特征性的分布于血管周隙;肿瘤细胞大多相似于中心母细胞,与反应性小淋巴细胞、巨噬细胞、活化的小胶质细胞以及反应性星形细胞混杂。免疫组织化学染色显示肿瘤细胞均弥漫强表达白细胞分化抗原20(CD20)及B细胞系特异性激活蛋白(PAX5),其中3例表达白细胞分化抗原10(CD10),7例均表达B细胞淋巴瘤因子6(Bcl-6)及多发性骨髓瘤致癌蛋白(MUM1),余5例均表达MUM1,增殖细胞核抗原(Ki-67)指数70%～90%。 结论原发中枢神经系统的弥漫大B细胞淋巴瘤是一种相对少见的淋巴瘤,以弥漫性分布于血管周隙的中心母细胞样细胞为特征;临床表现与其发生部位有关,掌握其共同的特征并结合免疫组织化学技术方能正确诊断。     

原发性皮肤弥漫性大B细胞性淋巴瘤(腿型)17例临床病理分析

目的探讨原发性皮肤弥漫性大B细胞性淋巴瘤(腿型)(PCDLBCLLT)的临床病理特点。方法回顾性分析17例PCDLBCLLT的临床资料、组织学形态和免疫组化标记。结果 17例PCDLBCLLT的发病年龄为31～86岁,平均64.4岁;其中男性9例,女性8例,男女之比为1.1∶1;主要发生于腿部和躯干部。组织学表现为弥漫分布的肿瘤细胞,以中心母细胞和免疫母细胞为主,核分裂象易见,肿瘤组织不累及表皮。免疫组化:肿瘤细胞表达B细胞相关抗原,bcl-2、MUM1、FOX-P1和bcl-6(+),Ki-67增殖指数为60%～90%。结论 PCDLBCLLT是一种独特类型的大B细胞性淋巴瘤,预后较差。     

弥漫大B细胞淋巴瘤治疗进展

非霍奇金淋巴瘤(non-Hodgkin lymphoma NHL)是恶性淋巴瘤的一大类型,在中国所占比例明显高于霍奇金淋巴瘤.弥漫大B细胞淋巴瘤(diffuse large B-cell lymphoma,DLBCL)是非霍奇金淋巴瘤中最为常见的一种类型,在临床、免疫表型及分子遗传学等方面具有高度异质性,其治疗方案也呈多样化.近10年来,DLBCL的诊断及治疗取得了重要进展,现就其规范化治疗方案及最新治疗研究进行阐述.     

c-FLIP does not correlate with response to immunochemotherapy treatment and outcome of patients with nodal diffuse large B-cell lymphoma

Cellular FLICE-inhibitory protein (c-FLIP) is a critical anti-apoptotic regulator that inhibits apoptosis-inducing ligand, (TRAIL)-induced apoptosis as well as chemotherapy-triggered apoptosis in malignant cells. The present study was designed to investigate the clinical and prognostic significance of c-FLIP expression in patients with nodal diffuse large B-cell lymphoma (DLBCL) treated with immunochemotherapy.     

Pidilizumab in the treatment of diffuse large B-cell lymphoma

Introduction: The programmed death-1 (PD-1) immune checkpoint pathway is an emerging target in the treatment of hematologic malignancies. Pidilizumab is an mAb that binds to PD-1 and is a safe and well-tolerated therapy. Recent data have shown clinical activity utilizing this strategy in diffuse large B-cell lymphoma (DLBCL).

Areas covered: The role of PD-1 expression in hematologic malignancies is explored. Recent clinical trials including the results of a Phase I trial in hematologic malignancies and a Phase II trial of pidilizumab following autologous hematopoietic stem-cell transplant (AHSCT) are reviewed.

Expert opinion: We review data that suggest that PD-1 is a promising target in the treatment and management of DLBCL. Changes in immune subsets following administration of pidilizumab are felt to represent on-target responses. The improvement in progression-free survival (PFS) following AHSCT supports a response to therapy. Importantly, the improvement in PFS for patients with positive FDG-PET/CT following AHSCT indicating residual disease further supports direct activity of pidilizumab in DLBCL.     

现实暴露疗法对弥漫性大B细胞淋巴瘤化疗患者心理状况的影响

目的 探究现实暴露疗法对弥漫性大B细胞淋巴瘤化疗患者心理状况的影响.方法 选择2017年6月—2020年6月收治的弥漫性大B细胞淋巴瘤化疗患者120例为研究对象,按性别、年龄、TNM分期有可比性的原则分为对照组和观察组,各60例,对照组采取常规护理,观察组在对照组基础上采用现实暴露疗法,比较两组心理弹性水平、焦虑抑郁状...     

Evaluation of a five-gene signature associated with stromal infiltration for diffuse large B-cell lymphoma

BACKGROUNDDiffuse large B-cell lymphoma (DLBCL) is a common non-Hodgkin lymphoma. The development of immunotherapy greatly improves the patient prognosis but there are some exceptions. Thus, screening for better biomarkers for prognostic evaluation could contribute to the treatment of DLBCL patients.AIMTo screen the novel mediators involved in the development of DLBCL.METHODSThe {"type":"entrez-geo","attrs":{"text":"GSE60","term_id":"60"}}GSE60 dataset was applied to identify the differentially expressed genes (DEGs) in DLBCL, and the principal components analysis plot was used to determine the quality of the included samples. The protein-protein interactions were analyzed by the STRING tool. The key hub genes were entered into to the GEPIA database to determine their expressions in DLBCL. Furthermore, these hub gene alterations were analyzed in cBioportal. The UALCAN portal was employed to analyze the expression of the hub genes in different stages of DLBCL. The Estimation of Stromal and Immune cells in Malignant Tumor tissues using Expression data Score was conducted to evaluate the correlation between the gene expression and tumor purity. The gene-gene correlation analysis was conducted in the GEPIA. The stromal score analysis was conducted in TIMER to confirm the correlation between the gene expression and infiltrated stromal cells. The correlation between the indicated genes and infiltration level of cancer-associated fibroblasts (CAFs) was also completed in TIMER with two methods, MCP-Counter and Tumor immune dysfunction and exclusion. The correlation between fibronectin (FN1) protein level and secreted protein acidic and cysteine-rich (SPARC) messenger ribonucleic acid expression was confirmed in the cBioportal.RESULTSThe top 20 DEGs in DLBCL were identified, and the principal components analysis plot confirmed the quality of the significant DEGs. The pairwise correlation coefficient analysis among all samples showed that these DEGs have a certain co-expression pattern. The DEGs were subjected to STRING to identify the hub genes, alpha-2-macroglobulin (A2M), cathepsin B (CTSB), FN1, matrix metallopeptidase 9 (MMP9), and SPARC. The five hub genes were confirmed to be overexpressed in DLBCL. The cBioportal portal detected these five hub genes that had gene alteration, including messenger ribonucleic acid high amplification and missense mutation, and the gene alteration percentages of A2M, FN1, CTSB, MMP9, and SPARC were 5%, 8%, 5%, 2.7%, and 5%, respectively. Furthermore, the five hub genes had a potential positive correlation with tumor stage. The correlation analysis between the five genes and tumor purity confirmed that the five genes were overexpressed in DLBCL and had a positive correlation with the development of DLBCL. More interestingly, the five genes had a significant correlation with the stromal infiltration scores. The correlation analysis between the fives genes and CAFs also showed a significant value, among which the top two genes, FN1 and SPARC, had a remarkable co-expression pattern.CONCLUSIONThe top DEGs were identified, and the five hub genes were overexpressed in DLBCL. Furthermore, the gene alterations were confirmed and the positive correlation with tumor purity revealed the overexpression of the five genes and close association with the development of DLBCL. More interestingly, the five genes were positively correlated with stromal infiltration, especially in CAFs. The top two genes, FN1 and SPARC, showed a co-expression pattern, which indicates their potential as novel therapeutic targets for DLBCL.     

弥漫性大B细胞淋巴瘤中miR-34a、FOXP1表达的相关性及临床意义

目的 研究弥漫性大B细胞淋巴瘤(DLBCL)中微小RNA(miR)-34a、叉头框蛋白P1(FOXP1)表达的相关性及临床意义.方法 选择2018年2月至2019年7月期间经达州市中心医院病理确诊的DLBCL组织79例和反应性增生淋巴结组织60例,采用荧光定量PCR检测miR-34a的表达水平、western blot...