IDO表达对CD20+弥漫大B细胞淋巴瘤RCHOP方案治疗的预后的影响

目的探讨IDO表达对CD20+弥漫大B细胞淋巴瘤(DLBCL)RCHOP方案治疗的预后的影响。方法回顾性选取经组织活检诊断为DLBCL的60例患者临床资料,所有患者均经免疫组化检测CD20蛋白阳性表达,先后通过RCHOP方案治疗,分析IDO阳性与阴性表达患者预后差异。结果非GCB型、临床分期Ⅲ~Ⅳ期、有B症状、化疗效果为PD+SD的CD20+DLBCL患者IDO表达阳性率高于GCB型、临床分期Ⅰ~Ⅱ期、无B症状、化疗效果为PR+CR患者(P<0.05)。IDO阳性患者1年、3年无进展生存率分别为72.22%、36.11%,低于IDO阴性患者的91.67%、70.83%(P<0.05);IDO阳性患者1年、3年总生存率分别为83.33%、50.00%,低于IDO阴性患者的95.83%、79.17%(P<0.05)。Logisitic回归分析显示非GCB型、临床分期为Ⅲ~Ⅳ期、有B症状、IPI评分为3~5分、IDO阳性表达均是导致CD20+DLBCL患者RCHOP方案治疗不良预后的独立危险因素。结论IDO高表达患者近期疗效较差,3年无进展与总生存率较低。IDO表达水平可以作为DLBCL患者独立预后因素。

Effects of IDO Expression on Prognosis of CD20+Diffuse Large B-cell LymphomaTreated with RCHOP Regimen

Objective To explore the effects of indoleamine2,3-dioxygenase(IDO)expression on prognosis of CD20+diffuse large B-cell lymphoma(DLBCL)treated with RCHOP regimen.Methods The clinical data of 60 patients who were confirmed with DLBCL by biopsy were retrospectively selected.The positive expression of CD20 protein was detected by immunohistochemistry.They were treated with RCHOP regimen.The differences of prognosis among patients with positive and negative expression of IDO were analyzed.Results The positive expression rate of IDO in CD20+DLBCL patients with non-GCB type,clinical staging at stage Ⅲ~Ⅳ,B symptoms and PD+SD chemotherapy effect was higher than that with GCB type,clinical staging at stage Ⅰ~Ⅱ,without B symptoms and with PR+CR chemotherapy effect(P<0.05).The 1-year and 3-year progression-free survival(PFS)rates in IDO-positive patients were 72.22% and 36.11%,which were lower than those in IDO-negative patients(91.67%,70.83%)(P<0.05).The 1-year and 3-year overall survival rates in IDO-positive patients were 83.33% and 50.00%,which were lower than those in IDO-negative patients(95.83%,79.17%)(P<0.05).Logisitic regression analysis showed that non-GCB type,clinical staging at stage Ⅲ~Ⅳ,B symptoms,IPI score of 3-5 points and positive expression of IDO were independent risk factors of poor prognosis in CD20+DLBCL patients treated with RCHOP regimen.Conclusion The short-term curative effect is relatively poorer,while 3-year PFS and overall survival rates are lower in patients with high IDO expression.The expression level of IDO can be applied as an independent prognostic factor in DLBCL patients.