弥漫大B细胞淋巴瘤survivin和caspase-3表达的临床意义

目的探讨弥漫大B细胞淋巴瘤survivin、caspase-3表达与临床预后的关系。方法收集1997年至2000年间初治弥漫大B细胞淋巴瘤94例,用免疫组化SP法检测其survivin、caspase-3表达情况。应用SPSS10．0软件进行生存分析,并对各临床指标与预后的关系进行单因素和多因素分析。结果94例弥漫大B细胞淋巴瘤的survivin和caspase-3阳性表达率分别为68．1％和76．6％,其表达与国际预后指数（IPI）显著相关（P〈0．05）。survivin和caspase-3表达阳性患者的复发率高,survivin阳性患者的5年生存率（31．3％）明显低于survivin表达阴性患者（64．0％,P〈0．05）。多因素分析显示,survivin表达是弥漫大B细胞淋巴瘤的独立预后指标。结论survivin和caspase-3可作为弥漫大B细胞淋巴瘤的疗效和预后指标,与IPI结合可在早期筛选出常规治疗预后不良的病例,有助于指导临床治疗,改善预后。

Clinical significance of survivin and caspase-3 expression in diffuse large B-cell lymphoma

OBJECTIVE: To investigate the expression of survivin and caspase-3, and its correlation with prognosis in diffuse large B-cell lymphoma (DLBCL). METHODS: From 1997 to 2000, 94 DLBCL patients were studied on the expression of survivin and caspase-3 detected by immunohistochemical stain. The relationship between the expression of surviving and caspase-3 and prognosis were analyzed by SPSS 10.0. RESULTS: The positive expression rate of survivin and caspase-3 was 68.1% and 76.6%, respectively. The expression of survivin and caspase-3 were significantly correlated with the "international prognostic index" (IPI) (P < 0.05). Patients with positive expression of survivin and caspase-3 were found to have higer replase risk, and patients with positive survivin expression had poorer overall 5-year survival than those with negative expression (31.3% vs 64.0%, P < 0.05). Positive survivin expression was found to be an independent poor prognostic index for DLBCL by Cox regression model. CONCLUSION: Survivin and caspase-3 are useful in therapeutic and prognostic assessment. Poor prognostic patients can be screened out in the early treatment period using expression of survivin and caspase-3 combined with IPI, which may help to improve the outcome of diffuse large B-cell lymphoma.