bcl-2蛋白对胃肠和结内弥漫性大B细胞淋巴瘤的预后意义

 目的 通过93例病例的临床病理学研究，探讨Bcl-2蛋白在原发胃肠道弥漫性大B细胞淋巴瘤(DLBCL)中的预后作用。 方法 收集北京大学医学部基础医学院病理系淋巴瘤研究室确诊为DLBCL，且用非利妥昔单抗化疗的患者93例。用免疫组织化学检测Bcl-2，CD10，Bcl-6，Mum-1表达情况。随访全部病人的治疗过程和预后。采用SAS 9.1统计学软件对所得资料行卡方检验、生存曲线分析及log-rank检验。 结果 原发于胃肠道弥漫性大B细胞淋巴瘤46例。Bcl-2(+)病例26例，完全缓解(CR)8例； Bcl-2(-)病例20例，完全缓解10例。 两者完全缓解率无显著性差异(χ2 检验，P= 0.1852)，两组的生存时间也无显著性差异(Log-Rank检验，P=0.4663)。原发于淋巴结弥漫性大B细胞淋巴瘤47例。Bcl-2(+)病例30例，完全缓解8例； Bcl-2(-)病例17例，完全缓解10例。两者完全缓解率存在显著性差异(χ2 验验，P=0.0293)，两组的生存时间也存在显著性差异(Log-Rank检验，P= 0.0470)。 结论 Bcl-2蛋白对原发淋巴结内DLBCL有预后提示意义，而在原发胃肠道DLBCL中无预后提示意义。

Prognostic significance of bcl-2 protein in primary gastrointestinal DLBCL and primary nodal DLBCL

Objective To explore the prognostic significance of bcl-2 protein in primary gastrointestinal DLBCL and primary nodal diffuse large B-cell lymphoma(DLBCL)by the clinical pathological analysis in 93 cases.Methods 93 cases of DLBCL without treatment of rituximab were collected from the haematopathological laboratory,the Department of Pathology of Beijing University Health Science Center.Immunohistochemical staining with Envision was used to assess the expression of bcl-2,CD_(10),bcl-6 and Mum1 and the treatment and prognosis of all cases followed up.The data were analyzed with Chi-square test,survival curve analysis and Log-Rank test by SAS 9.1.Results There were 46 patients of primary gastrointestinal DLBCL,in which 8 cases out of 26 patients with bcl-2(+)achieved CR and 10 cases out of 20 patients with bcl-2(-)achieved CR.There was no significant difference in CR(Chi-square test,P=0.1852)and OS(Log-Rank test,P=0.4663).Meanwhile,there were 47 patients of primary nodal DLBCL in this study,in which 8 cases out of 30 patients with bcl-2(+)achieved CR,10 cases out of 17 patients with bcl-2(-)achieved CR.There was a significant difference in CR(Chi-square test,P=0.0293)and OS(Log-Rank test,P=0.0470).Conclusion bcl-2 protein has a prognostic significance in primary nodal DLBCL but not in the primary gastrointestinal DLBCL.