胃肠道弥漫大B细胞淋巴瘤CD10、Bcl-6和VEGF与预后的相关性研究

目的：探讨原发于胃肠道的弥漫大 B 细胞淋巴瘤（PGI-DLBCL）的临床特征，CD10、Bcl-6和 VEGF 表达，分析其与预后的相关性。方法收集66例病理确诊原发 PGI-DLBCL 患者的临床资料，采用免疫组化法检测肿瘤组织CD10、Bcl-6及 VEGF 表达水平；应用 Hans 分型法、Kaplan-Meier 法、Log-rank 检验对患者进行分型，分析临床特征、CD10、Bcl-6及 VEGF 表达与无进展生存期（ PFS）相关性。结果66例患者，原发胃部36例（54.5%），原发肠道30例（45.5%）。生发中心型（GCB）39例（59.1%），非生发中心型（non-GCB 型）27例（40.9%）。肿瘤分期、国际预后指数（IPI）评分与 PFS 呈负相关性（P <0.05）。GCB 中位 PFS 为21.50个月，non-GCB 中位 PFS 12.00个月。Bcl-6阳性表达29例（43.9%），CD-10阳性表达23例（34.8%），VEGF 阳性表达29例（43.9%）；单因素分析结果提示 CD10、Bcl-6阳性表达与 PFS 呈正相关性（ P <0.05），而 VEGF 阳性表达与PFS 呈负相关性（P <0.05）；CD10、Bcl-6、VEGF 表达与临床特征之间无明显相关性。Cox 多因素预后分析提示治疗结果、Bcl-6及 VEGF 为影响生存时间的独立影响因素。结论PGI-DLBCL 是一类高侵袭性、高特异性的恶性肿瘤，Hans分型、肿瘤分期、IPI 评分、VEGF、CD10、Bcl-6表达均与其预后有相关性。

The relationship between CD10,Bcl-6,VEGF with the prognosis in the primary gastrointestinal diffuse large B-cell lymphoma

Objective To investigate the correlation between the expression of CD10,Bcl-6,VEGF with clinical characteristics and the prognosis in the primary gastrointestinal diffuse large B-cell lymphoma. Methods The clini-cal characteristics data of 66 patients with PGI-DLBCL were determined the levels of CD10,Bcl-6 and VEGF by immunohisto-chemical staining. Analyzed their correlation via Kaplan-Meier method and Log-rand test. Results Among those 66 patients,there were 36 cases(54. 5% )of primary stomach,while other 30 cases(45. 5% )were primary intestinal. 39 cases were GCB and 27 cases were non-GCB. The tumor stage and IPI were inverse propor-tion with the prognosis. The median progression-free-survival of GCB was 21. 50 months while non-GCB was 12. 00 months. The positive expression rate of Bcl-6 was 43. 9%(29 / 66)while that of CD10 was 34. 8%(23 / 66)and there were 29 cases(43. 9% )with positive expression of VEGF. Log-rank test revealed there was a positive correc-tion between the positive impression of CD10,Bcl-6 and PFS. On the contrary,the relationship between the ex-pressions of VEGF and PFS was negative. The expressions of CD10,Bcl-6 and VEGF were not correlated with clini-cal features. Cox multivariable analysis showed that the curative effect,the expressions of Bcl-6 and VEGF were in-dependent prognostic factors. Conclusion PGI-DLBCL is a highly invasive and heterogeneous malignancy. The stage of disease,the Hans classification,the level of IPI,the expression of CD10,Bcl-6 and VEGF may play im-portant roles in predicting the curative effect and the prognosis of the disease.