CD68＋淋巴瘤相关巨噬细胞在弥漫性大B细胞淋巴瘤中的表达及其临床意义

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

Expression and Clinical Significance of CD68+ Lymphoma Associated Macrophage in Diffuse Large B-Cell Lymphoma

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