R-CHOP和CHOP方案治疗两种亚型弥漫大B细胞淋巴瘤患者的近期疗效

背景与目的：根据肿瘤细胞起源不同,可将弥漫大B细胞淋巴瘤（diffuselarge Bcelllymphoma,DLBCL）分为生发中心来源（germinalcenter Bcell like,GCB）及非生发中心来源（non-GCB）两种亚型。在以CHOP方案为标准的化疗基础上,前者预后优于后者。本研究通过比较R-CHOP（Rituximab联合CHOP）和CHOP方案治疗不同亚型DLBCL患者的近期疗效,寻找初诊DLBCL患者最佳一线治疗方案。方法：将2006年11月至2008年2月中山大学肿瘤防治中心内科收治的83例初治DLBCL患者分为GCB和non-GCB两组。按照修订版淋巴瘤疗效评价标准,比较接受R-CHOP或CHOP方案治疗患者的近期疗效;观察Bcl-2在两种亚型中的表达情况,并分析其与近期疗效的关系。结果：83例DLBCL患者中GCB组35例（42．2％）,non-GCB组48例（57．8％）。GCB组一线化疗近期总缓解率74．3％,non-GCB组60．4％,两组相比差异有显著性（P=0．006）。Bcl-2在GCB和non-GCB两亚组的表达差异没有显著性：Bcl-2阳性患者采用R．CHOP方案治疗的近期缓解率（75．6％）明显高于用CHOP方案治疗者（47．8％）,两组相比差异有显著性（P=0．031）：采用不同方案化疗的Bcl-2阴性患者的近期缓解率则差异无显著性（P〉0．05）。结论：GCB组患者接受标准R—CHOP或CHOP方案治疗近期缓解率高于non-GCB组,提示预后良好。加用Rituximab可提高Bcl-2阳性患者的近期缓解率。     

弥漫大B细胞淋巴瘤原发部位和预后与免疫分型的相关性研究

目的:探讨弥漫大B细胞淋巴瘤(diffuse large B-cell lymphoma,DLBCL)原发部位和临床预后与免疫分型的关系.方法:收集经病理证实的DLBCL病检存档石蜡包埋组织标本53例,应用组织芯片免疫组化方法通过测定CD10、BCL-6和MUM1的表达,将DLBCL分为GCB型和non-GCB型.结果:经免疫学分型后,GCB型占45.3%(24/53),non-GCB型占54.7%(29/53);原发于淋巴结内23例,其中GCB型14例,non-GCB型9例;原发于淋巴结外30例,GCB型占10例,低于淋巴结内组中所占的比例,二者的差异有统计学意义(P<0.05);完全缓解(CR)的DLBCL患者中,GCB型17例,non-GCB型12例,两种分型的缓解率有显著性差异(P<0.05);生存分析显示GCB型患者与non-GCB型存在明显的差异,GCB患者的生存期长于non-GCB患者.结论:53例DLBCL中,non-GCB型DLBCL在结外的发生率显著高于结内,原发于结外患者多数为non-GCB型;GCB型DLBCL患者的预后明显优于non-GCB型.     

介于弥漫大B 细胞淋巴瘤和伯基特淋巴瘤之间的未分类淋巴瘤

目的:分析介于弥漫大B 细胞淋巴瘤和伯基特淋巴瘤之间的未分类的B 细胞淋巴瘤（B-cell lymphoma ,unclassifiable,with features intermediate between DLBCL and Burkitt lymphoma,DLBCL/BL）的临床特点、治疗与预后,增加对该病的认识。方法:收集郑州大学第一附属医院2013年1 月至2014年12月收治的13例DLBCL/BL患者临床病理资料,采用Kaplan-Meier 法进行生存分析,采用Logrank 检验对临床分期、年龄、LDH 水平、IPI 评分、初治化疗方案等进行单因素分析。结果:13例患者中12例存在结外侵犯,13例患者的中位OS为10个月,中位PFS 为6 个月。单因素分析显示IPI 评分、LDH 水平与预后有统计学相关性,行CHOP、CHOP 样与高强度化疗方案患者之间生存差异具有统计学意义（P = 0.054）。 结论:DLBCL/BL恶性程度高,生存期短,结外侵犯多见,对CHOP 及CHOP 样方案治疗反应差,高强度化疗可能改善预后,IPI 评分≥ 3 分及 LDH 升高是其不良预后因素。      

弥漫大B细胞淋巴瘤免疫表型及临床参数与其预后的关系

目的探讨采用R-CHOP方案治疗的弥漫大B细胞淋巴瘤(DLBCL)的免疫表型及临床参数与其预后的关系。方法采用免疫组化SP法,检测57例DLBCL中CD10、bcl-6、MUMl和CD5的表达,根据Hans分型将其分为GCB型和non-GCB型。结果 57例DLBCL中表达CD10、bcl-6、MUM1和CD5分别有9例(15.8%)、36例(63.2%)、34例(59.6%)、4例(7.0%);GCB型17例(29.8%)、non-GCB型40例(70.2%)。57例DLBCL中死亡19例,GCB型预后与non-GCB型相比差异无统计学意义(P=0.132);CD5阳性患者死亡率高,但与CD5阴性者相比差异无统计学意义(P=0.594)。Ⅲ~Ⅳ期和年龄>60岁DLBCL患者死亡率高(P=0.001、P=0.017)。结论应用R-CHOP方案治疗的DLBCL其预后与患者年龄和肿瘤临床分期有关,与Hans分型无关。     

miR-320d与弥漫大B细胞淋巴瘤预后的相关性研究

目的 探讨miR-320d表达与弥漫大B细胞淋巴瘤（DLBCL）预后的关系.方法 应用EnVision法对山西省肿瘤医院有随访资料的原发于淋巴结的DLBCL 62例石蜡标本进行CD20、CD3、CD10、bcl-6、Mum-1免疫标记检测,根据Hans分类方法将DLBCL分为生发中心B细胞（GCB）型和非生发中心B细胞（non-GCB）型.采用安捷伦16.0高密度芯片对24例DLBCL石蜡标本进行miRNA表达谱筛选,用实时荧光定量PCR方法对62例DLBCL石蜡标本进行miR-320d表达验证.将1 1例淋巴结反应性增生标本作为对照.结果 62例DLBCL中,GCB型22例（35.5％）,non-GCB型40例（64.5％）,GCB型miR-320d表达水平是non-GCB型的3.43倍（P=0.034）.miR-320d在对照组的表达量是DLBCL的5.65倍（P＜ 0.001）.单因素分析示DLBCL中miR-320d低表达组总生存期低于高表达组,差异有统计学意义（P=0.021）.多因素Cox回归模型分析示62例DLBCL中,miR-320d低表达（RR=2.434,95％CI1.148～5.159,P=0.020）为独立于国际预后指数（IPI）的预后不良因素.结论 miR-320d表达下调预示DLBCL预后不良.     

弥漫大B细胞淋巴瘤免疫亚型与临床特征及疗效的关系

目的探讨弥漫大B细胞淋巴瘤(DLBCL)免疫亚型与一线CHOP化疗方案的疗效关系。方法采用免疫组化链霉素抗生物素蛋白-过氧化物酶连接法(SP)检测60例DLBCL石蜡组织中MUM-1、bcl-6和CD10的表达,确定弥漫大B细胞淋巴瘤免疫亚型。60例患者均采用CHOP或CHOP样方案化疗,观察各组的疗效及不良反应。结果弥漫大B细胞淋巴瘤GCB型和非GCB型各30例,GCB型组患者完全缓解率、稳定率合有效率分别为56.7%、6.7%和93.3%,非GCB型租患者完全缓解率、稳定率及有效率分别为26.7%、13.3%和76.7%,两组患者疗效差异有统计学意义(P<0.05)。GCB型组患者3年生存率明显高于非GCB型组,差异有统计学意义(P<0.05)。两组患者不良反应差异无统计学意义(P>0.05)。结论 DLBCL免疫学亚型与CHOP方案疗效存在一定关系,可以作为预后判断的重要因素。     

免疫分型标记物和CD43在非特指弥漫性大B细胞淋巴瘤中的表达及临床意义

目的 探讨免疫分型标记物和CD43在非特指弥漫性大B细胞淋巴瘤(DLBCL NOS)中的表达及其临床意义.方法 收集120例DLBCL NOS临床病理资料进行分析.采用免疫组化法检测CD10、bcl-6、MUM-1和CD43的表达,根据Hans分型将其分为GCB型和non-GCB型.结果 120例DLBCL,NOS中GCB型和non-GCB型分别为38例和82例,Hans分型与DLBCL NOS预后无关(P＞0.05).120例DLBCL NOS中CD43阳性33例(27.5％),CD43表达与性别、临床分期和免疫分型均无关(P＞0.05),与年龄(P=0.036)和生存状态(P=0.004)有关.结论 DLBCL NOS预后差与CD43阳性表达有关,与Hans分型无关.     

利妥昔单抗联合CHOP与单用CHOP方案治疗初治弥漫大B细胞型淋巴瘤的对比研究

目的:比较利妥昔单抗(商品名:美罗华)联合CHOP(环磷酰胺,阿霉素,长春新碱和泼尼松)与单用CHOP方案化疗治疗弥漫大B细胞淋巴瘤(diffuse large B cell lymphoma,DLBCL)的临床疗效。方法:根据患者的意愿,49例DLBCL患者分别接受6疗程CHOP方案或CHOP加利妥昔单抗方案化疗,每3周1疗程,共6个疗程。结果:R-CHOP组的CR率高于CHOP组,但差异无统计学意义(82.6%VS 65.4%,P=0.173)。中位随访时间为35月(4-66月),R-CHOP组及CHOP组的3年OS分别为75.0%±19.6%,54.9%±20.4%,P=0.043;而3年EFS分别为69.7%±20.9%,45.8%±20.6%,P=0.029。R-CHOP组的3年OS及EFS优于CHOP组,差异有统计学意义。两组患者的不良反应无明显差别。结论:与单用CHOP方案相比,利妥昔单抗联合CHOP方案明显提高DLBCL患者的EFS及OS,而不良反应无明显增加。     

放疗对早期弥漫大B细胞淋巴瘤化疗后CR患者的价值研究

目的 探讨放疗在早期弥漫大B细胞淋巴瘤(DLBCL)化疗后达CR患者中的地位。方法 回顾分析2004—2012年本院治疗的376例Ⅰ、Ⅱ期DLBCL患者资料,均接受至少3个周期CHOP和利妥昔单抗+CHOP方案化疗(R-CHOP)后达CR者。R-CHOP组92例,R-CHOP+放疗组79例,CHOP+放疗组98例,CHOP组107例。放疗为累及野照射30~56 Gy。Kaplan-Meier法计算生存率并Logrank法检验,Cox回归模型多因素预后分析。结果 5年样本量为188例。全组5年DFS、OS分别为80.7%、87.6%,R-CHOP+放疗组和R-CHOP组的分别为94.9%和88.1%(P=0.030)、97.9%和86.0%(P=0.026),CHOP+放疗组和CHOP组的分别为74.2%和71.4%(P=0.623)、87.0%和82.1%(P=0.420)。多因素分析显示吸烟指数<500、IPI<2、加用利妥昔单抗是预后有利因素(P=0.034~0.000)。结论 放疗对早期DLBCL可以提高R-CHOP化疗后CR者的DFS和OS。建议DLBCL使用含利妥昔单抗的化疗,R-CHOP化疗后应接受放疗。希望开展随机对照研究进一步证明该结果。     

利妥昔单抗联合CHOP与单用CHOP方案治疗初治弥漫大B细胞型淋巴瘤的对比研究

目的：比较利妥昔单抗（商品名：美罗华）联合CHOP（环磷酰胺,阿霉素,长春新碱和泼尼松）与单用CHOP方案化疗治疗弥漫大B细胞淋巴瘤（diffuse large B cell lymphoma,DLBCL）的临床疗效。方法：根据患者的意愿,49例DLBCL患者分别接受6疗程CHOP方案或CHOP加利妥昔单抗方案化疗,每3周1疗程,共6个疗程。结果：R-CHOP组的CR率高于CHOP组,但差异无统计学意义（82.6%VS 65.4%,P=0.173）。中位随访时间为35月（4-66月）,R-CHOP组及CHOP组的3年OS分别为75.0%±19.6%,54.9%±20.4%,P=0.043;而3年EFS分别为69.7%±20.9%,45.8%±20.6%,P=0.029。R-CHOP组的3年OS及EFS优于CHOP组,差异有统计学意义。两组患者的不良反应无明显差别。结论：与单用CHOP方案相比,利妥昔单抗联合CHOP方案明显提高DLBCL患者的EFS及OS,而不良反应无明显增加。     

Rituximab plus Ifosfamide,Carboplatin and Etoposide for T-Cell/Histiocyte-Rich B-Cell Lymphoma Arising in Nodular Lymphocyte-Predominant Hodgkin's Lymphoma

A small subset of patients with nodular lymphocyte-predominant Hodgkin''s lymphoma (NLPHLs) develop a non-Hodgkin lymphoma either concurrently or subsequently, usually T-cell/histiocyte-rich B-cell lymphomas (T/HRBCL), which are subtypes of diffuse large B-cell lymphomas (DLBCL). The standard treatment of DLBCL patients is rituximab-based chemotherapy with cyclophosphamide, adriamycin, vincristine and prednisolone. However, the administration of this chemotherapy regimen to patients with DLBCL arising in NLPHL brings concern about the cardiac toxicity of anthracycline because the majority of these patients had already received anthracycline-based chemotherapy with doxorubicin, bleomycin, vinblastine and dacarbazine at the time of NLPHL. Herein, we report 2 patients with sequential transformation of NLPHL to T/HRBCL. They initially presented with limited-stage NLPHL and subsequently developed T/HRBCL after 16 and 8 months, respectively. At the time of T/HRBCL, they were treated with rituximab, ifosfamide, carboplatin and etoposide, and complete responses were obtained.Key Words: Transformation, Nodular lymphocyte-predominant Hodgkin''s lymphoma, T-cell/histiocyte-rich B-cell lymphoma, Chemotherapy     

Molecular Subtypes,Apoptosis and Proliferation Status in Indonesian Diffuse Large B-Cell Lymphoma Cases

Objective: The diffuse large B-cell lymphoma (DLBCL) has two major molecular subtypes, germinal center B-cell-like (GCB) and non-GCB. These have differing behavior which affects overall patient survival. However, immunohistochemistry based molecular subtyping of Indonesian DLBCLs has been limited. This was the focus of the present study, with a focus of attention on the apoptotic index (AI) and the proliferation index (PI) of the two molecular subtypes. Materials and Methods: During the study period of 3.5 years, a total of 98 cases of DLBCL were identified. Molecular subtypes and PI were determined by immunohistochemistry and TUNEL method was used to determine the AI. Result: GCB accounted for 31 cases (31.6%) and non-GCB the remainder (68.4%). Gender showed a slight male predominance (54 cases, 55.1%), with a higher incidence in the extra-nodal region (57 cases, 58.2%). The AI and PI were significantly higher in GCB (pConclusion: The findings indicate that the non-GCB subtype is more common than GCB in Indonesian DLBCL. GCB features significantly higher PI and AI, which themselves appear linked.     

弥漫大B细胞性淋巴瘤分子亚型的蛋白表达研究

目的：在蛋白水平上研究国人弥漫性大B细胞淋巴瘤（diffuse large B-cell lymphoma,DLBCL）分子分型的蛋白表型特点,为DLBCL的病理诊断、预后和治疗提供依据。方法：取DLBCL标本52例行HE染色和免疫组化染色。在形态学分型的基础上,利用CD10、MUM1和bcl-6免疫标记对DLBCL进行分子分型,分为生发中心样B细胞样组（germi-nal center B-cell-like,GCB）和非生发中心样B细胞样组（non-germinal center B-cell-like,non-GCB）,分析其在DLBCL中的构成比,及CD10、MUM1和bcl-6的表达情况。结果：本组DLBCL中,non-GCB的构成比超过GCB（69.2%/30.8%）;统计学分析表明,GCB组间CD10、bcl-6、CD10/bcl-6的表达率的差异有显著性意义,其中CD10的表达率最高,bcl-6其次,CD10/bcl-6最低;non-GCB组间MUM1、MUM1/bcl-6的表达率的差异有显著性意义。结论：我国的DLBCL多起源于后生发中心B细胞,以non-GCB为主,预后较差。DLBCL在CD10、MUM1和bcl-6表达的差异对判定GCB组和non-GCB组有意义。     

Gene expression profiling of primary vitreoretinal lymphoma

The characteristics of tumor cells of primary vitreoretinal lymphoma (PVRL) have not been defined, although researches have shown that most cases are of diffuse large B‐cell lymphoma (DLBCL). To determine the subtype and biological characteristics of tumor cells of PVRL, we performed a gene expression profiling analysis. RNA was extracted from the vitreous fluid of 7 PVRL patients and from nodal samples of 10 DLBCL patients: 6 of germinal center B‐cell (GCB) type and 4 of activated B‐cell (ABC) type determined by Hans’ criteria. Six PVRL samples showed gene expression profiles that were similar to each other. The patterns were different from those of the ABC‐type nodular DLBCL but relatively close to those of the GCB‐type nodular DLBCL. Interestingly, all of the 6 examined PVRL samples had either MYD88^L265P or mutation in the immunoreceptor tyrosine‐based activation motif (ITAM) region of CD79B. Five PVRL patients with similar gene expression profiles were treated with a standardized regimen: intravitreal administration of methotrexate (MTX) followed by six courses of systemic high doses of MTX. As a result, 2 patients had CD79B mutations and showed early central nervous system (CNS) progression. Patients without CNS progression did not have this mutation. In conclusion, PVRL had unique genetic features: an expression pattern different from ABC‐type and relatively close to GCB‐type DLBCL. CD79B mutations showed potential to serve as prognostic markers for CNS progression.     

初治弥漫大B细胞淋巴瘤患者MYD88基因突变的临床特征及预后分析

目的:探讨MYD88基因突变对初治弥漫大B细胞淋巴瘤（diffuse large B-cell lymphoma,DLBCL）的临床特征及预后的影响。方法:收集2013年1月至2015年1月空军军医大学第二附属医院血液科的74例初治DLBCL患者,回顾分析MYD88突变组（MYD88mut）和MYD88野生组（MYD88wt）患者的临床特征及治疗效果。结果:74例DLBCL患者中,MYD88mut组和MYD88wt组患者性别、年龄、ECOG评分、LDH、Ann Arbor分期、结外侵犯及IPI评分比较差异无统计学意义。MYD88mut组主要为ABC亚型（75.00%）。12例MYD88mut突变均为错义突变,其中8例氨基酸改变为L265P。MYD88mut组2周期R-CHOP方案完全缓解率（complete remission,CR）为41.67%,部分缓解率(partial remission,PR)为33.33%,客观有效率(objective effective,OR)为75.00%。MYD88wt组分别为77.42%、11.29%和88.71%。2组比较,2周期CR率具有统计学差异（P=0.030 4）。生存分析结果显示,MYD88mut组及MYD88wt组患者5年OS分别为54.98%与73.53%,PFS分别为48.61%与66.54%,2组比较,OS及PFS均具有统计学差异（P=0.003 4,P=0.031 9）。结论:MYD88突变主要存在于DLBCL的ABC亚型,且MYD88突变提示其预后不良。     

Analysis of genomic copy number alterations of malignant lymphomas and its application for diagnosis

Array-based comparative genomic hybridization (array CGH) enables us to detect the genomic copy number alterations of cancers with high resolution. Our established array CGH platform consists of 2,304 BAC/PAC clones covering the whole genome at 1.3-mega base resolutions. Using this technique, we were thus able to reveal disease-specific genomic alterations and the candidate target genes in various lymphomas. We herein report the characteristic genomic alterations of malignant lymphomas including diffuse large B-cell lymphoma (DLBCL), follicular lymphoma (FL) and adult T cell lymphoma/leukemia (ATLL). The combined use of the array CGH data with gene expression profiling and specific gene rearrangement analyses further delineated the subtype-specific genomic alterations. For instance, we revealed that activated B-cell-like DLBCL is characterized by a gain of chromosome 3, 18q and loss of 9 p21, whereas the germinal center B-cell-like DLBCL is characterized by a gain of 2p15, 7q, and 12q. Among these genomic alterations,we found the 9 p21 loss (p16INK4a locus) to be the most aggressive type of DLBCL. Comparisons of the genome profiles of FL,both with and without BCL2 rearrangement, also revealed the existence of a unique subgroup: trisomy 3 FL. Comparison of genome profiles between acute type and lymphoma types of adult T cell lymphoma also demonstrated that acute and lymphoma types are genomically distinct subtypes, and thus may develop tumors via distinct genetic pathways. In addition to identifying disease-specific genomic alterations, we also discovered several target genes of the genomic gains and losses. Furthermore,we developed a computer algorithm to classify lymphoma diseases or subtypes on the basis of copy number gains and losses. We applied the algorithm to the classifications of DLBCL and MCL diseases and ABC and GCB subtypes. The method correctly classified the DLBCL and MCL diseases at 89%, and ABC and GCB subtypes at 83%. These results demonstrate that copy number gains and losses detected by array CGH could be used for classifying lymphomas into biologically and clinically distinct diseases or subtypes. The genomic copy number alterations detected by array CGH are therefore considered to have the potential to help diagnose or classify different disease entities and tumor subtypes.     

不同原发部位弥漫大B细胞淋巴瘤临床病理特点及预后比较

目的 比较原发结外与结内弥漫大B细胞淋巴瘤（DLBCL）患者的临床病理特点及预后方面的差异.方法 回顾分析2007年1月至2012年12月134例DLBCL患者的临床病理特征及治疗疗效.结果 DLBCL 134例,占同期收治非霍奇金淋巴瘤（NHL）的52.14％（134/257）,结外DLBCL共93例占总体DLBCL的69.4％.结外DLBCL分期为Ⅲ～Ⅳ期者占55.9％（52/93）,结内DLBCL中Ⅲ～Ⅳ期者占75.6％（31/41）,差异有统计学意义（P=0.035）.结外DLBCL中乳酸脱氢酶升高者占33.3％（31/93）,而结内DLBCL中升高者占58.5％（24/41）,差异有统计学意义（P=0.008）.其他临床特征如出现B症状、大肿块、骨髓浸润、红细胞沉降率升高的比例及美国东部肿瘤协作组（ECOG）评分、国际预后指数（IPI）评分差异均无统计学意义（均P＞0.05）.结外与结内DLBCL生发中心及非生发中心起源出现的比例差异无统计学意义（P=0.623）.结外与结内DLBCL的3年总生存率分别为73.2％、55.2％,3年疾病无进展生存率分别为46.3％、44.1％,差异均无统计学意义（P值分别为0.065、0.748）.结论 原发结外DLBCL的发病率较高,与结内DLBCL相比其临床分期较早,肿瘤负荷较低,但两者的免疫表型、分化特征及预后无明显差异.     

The GCB subtype of diffuse large B-cell lymphoma is less frequent in Asian countries

Patients with the germinal center B-cell-like (GCB) subtype of diffuse large B-cell lymphoma (DLBCL) have a significantly better survival rate than those with non-GCB DLBCL. Several studies have examined the proportions of GCB and non-GCB subtypes in large series of DLBCL patients, but it remains unclear if these proportions are the same in different countries. We performed an immunohistochemical analysis of the numbers of GCB and non-GCB subtypes in a large number of patients with DLBCL in Japan and compared the results with literature data for other countries. We found that 71 of 248 patients (29%) had the GCB phenotype and 177 patients (71%) had the non-GCB subtype of DLBCL among our patient population. Assessment of data collected from other studies showed that 31% of DLBCL patients (102/330) have the GCB subtype in Asian countries, but 50% (206/416) express GCB phenotypes in Western countries; based on these data, the occurrence of the GCB subtype of DLBCL was significantly less in Asian countries (p<0.001). Since patients with the GCB phenotype of DLBCL have better survival, future studies of DLBCL should recognize the difference in the proportions of GCB and non-GCB subtypes of DLBCL between Asian and Western populations.     

线粒体DNA D-环区单核苷酸多态性与弥漫大B细胞淋巴瘤的相关性

目的：探讨线粒体DNA（mitochondrial DNA,mtDNA）D-环区的单核苷酸多态性（single nucleotide polymorphisms,SNP）与弥漫大B 细胞淋巴瘤（diffuse large B cell lymphoma,DLBCL）患者癌症风险和预后的关系。方法：选取1991 年7 月至2012 年7 月在河北医科大学第四医院血液科接受治疗的108 例DLBCL患者的血液样本,同期159 例健康成人血液样本作为对照。常规提取DNA,进行PCR扩增和SNP位点基因型分析,通过病例对照研究调查了D-环区SNP风险状况。结果：核苷酸微小等位基因73A/G、263A/G、315C/C插入与DLBCL的风险降低有关,核苷酸微小等位基因200G/A与DLBCL的风险增加有关。评估D-环SNP在DLBCL患者的预测能力,5 个SNP位点通过对数秩检验被确认对DLBCL生存预测存在单因素分析统计学意义,多因素分析确认等位基因16304 为DLBCL预后的独立预测因素,16304C患者的生存期明显短于16304T患者（RR=0.513,95% CI为0.266~0.989;P<0.05）。结论：通过对mtDNA D-环区SNP分析可以帮助确定DLBCL的发生风险及高危预后亚组。