弥漫大B细胞淋巴瘤预后的相关因素探讨

目的:探讨弥漫大B细胞淋巴瘤(DLBCL)中微血管密度、Ki-67标记指数、bcl-6阳性率与患者预后的关系.方法:应用免疫组织化学染色法检测血管内皮细胞特异性标记物CD34和Ki-67、bcl-6的表达,通过形态学计量法计数肿瘤内微血管密度.结果:1)肿瘤微血管密度与Ki-67标记指数有关(P＜0.01),与bcl-6表达阳性率无关;2)Kaplan-Meier分析显示微血管计数≤21.5(×200倍)的弥漫大B细胞淋巴瘤预后较好,而微血管计数＞21.5(×200倍)预后较差:3)肿瘤细胞Ki-67的标记指数值在28.2%～85.6%之间,中位数59.4%,标记指数＞59.4%较≤59.4%者预后差:4)bcl-6表达阳性率在12.4%～90.8%之间,中位数42.0%,阳性率＞42.0%较≤42.0%者预后好.结论:弥漫大B细胞淋巴瘤微血管密度计量、Ki-67标记指数和bcl-6阳性率是评价患者预后的重要指标.

Multivariate Analysis of the Parameters Related to Recurrence of Diffuse Large B Cell Lymphoma

Objective: To investigate the relationship between microvessel density (MVD), ki- 67and bcl- 6 as well as the prognosis in diffuse large B- cell lymphoma. Methods: Specific endothelialcell markers CD34 and the ki- 67 and bcl- 6 gene expression were detected with immunohistochemistryand microvessel density was counted by morphometry. Results: 1) There was a significant correlation-ship between the MVD and the ki- 67 labelling index but bcl- 6; 2) The microvessel count was associ-ated with overall survival by Kaplan- Meier analysis. An average blood vessel count of less than 21.5suggested a better survival, but a higher vessel count of more than 21.5 showed a trend to worsen theoverall survival; 3) A ki- 67 labelling index of less than 59.4 suggested a better survival, but a higherki- 67 labelling index of more than 59.4 showed a trend to worsen the overall survival; 4) A bcl- 6 posi-tive of more than 42.0 suggested a better survival, but a lower bcl- 6 positive of less than 42.0 showed atrend to worsen the overall survival. Conclusion: The results suggest a significant correlationship a-mong MVD, ki- 67 labelling index, bcl- 6 positive and prognosis. Moreover MVD, ki- 67 and bcl- 6 maybe the useful prognostic indicators in diffuse large B- cell lymphoma.