弥漫大B细胞淋巴瘤的免疫学亚型与预后的关系

目的 根据不同的免疫组化分型方法将弥漫大B细胞淋巴瘤(diffuse large B-cell lymphoma,DLBCL)分成预后不同的亚型,并探讨各分型方法对国内病例的适用性.方法 利用免疫组化检测121例DLBCL的CD10、BCL-6、MUM1和CD138的表达,构建了3种分型方法:方法1,CD10阳性者归入GCB亚型,若CD10阴性而BCL-6阳性且MUM1阴性者归入GCB亚型,其余归入non-GC型;方法2,CD10和/或BCL-6阳性,而MUM1和/或CD138阴性者归入A组,MUM1和/或CD138阳性者归入B组,CD10和BCL-6阴性,而MUM1和/或CD138阳性者归入C组,四者均阴性者归入D组;方法3,CD10阳性者归入GCB亚型,CD10阴性时若MUM1阴性者归入GCB亚型,MUM1阳性者则归入non-GCB亚型.评测各临床及生物学因素与预后的关系.结果 CD10、BCL-6、MUM1和CD138的阳性率分别为21.5%(26/121)、32.2%(39/121)、32.2%(38/118)和2.5%(3/118),其中CD10和BCL-6阳性者预后较好(OS, P=0.023 1和0.027 8),而MUM1阳性者预后较差(OS, P=0.013).在方法1中,non-GCB组(占67.8%)5年总生存率OS(27.6%)和无进展生存率PFS(24.69%)明显差于GCB组;根据方法3,non-GCB组患者比例减少(占27.5%),5年OS(18.96%)和PFS(15.08%)更差,并且独立于IPI和治疗起作用.结论 各分型方法均在预后分析中起作用,尤以方法3可以识别部分高危患者,在本组病人中更具有适用性.

Immunohistochemical profiles and their prognostic role in diffuse large B-cell lymphoma

Objective Try to subclassify diffuse large B-cell lymphoma (DLBCL) into different prognostic subgroups according to different immunohistochemical algorithms and to discuss their applicability in Chineses patients. Methods We detected the expression of CD10,BCL-6,MUM1,and CD138 in 121 cases by immunohistochemistry and constructed three subtyping algorithms. According to algorithm-1,cases were assigned to GCB group if CD10 was positive,and if CD10 was negative but BCL-6 was positive and MUM1 was negative; the...