IDO 在弥漫大 B 细胞淋巴瘤中的表达及其临床意义

目的：探讨弥漫大 B 细胞淋巴瘤组织中吲哚胺2，3双加氧酶（indoleamine 2，3- dioxygenase，IDO）的表达及意义。方法：收集2007年1月至2012年12月四川省肿瘤医院存档蜡块63例，其中弥漫大 B 细胞淋巴瘤组织41例，炎症反应性增生组22例，采用免疫组织化学技术检测 IDO 的表达，并分析与临床病理资料的关系及其临床意义。结果：弥漫大 B 细胞淋巴瘤组织中 IDO 阳性率为56.1%，明显高于反应性增生炎症组织22.7%，差异有统计学意义，P =0.011；IDO 表达水平与 Hans 分型、B 症状具有相关性，P =0.000、0.035；IDO的表达与患者的年龄、性别、分期、结外受侵数目、IPI、ECOG、LDH 无明显相关，P ﹥0.05；IDO 与弥漫大 B 细胞淋巴瘤的近期疗效具有相关性，P =0.001；Log - rank 单因素生存分析显示 IDO 的表达水平、Hans 分型、B 症状及 IPI 评分差异有统计学意义，P =0.009、0.003、0.000、0.030；Cox 多因素生存分析，仅 IDO 表达水平具有显著性差异，P =0.024。结论：IDO 的高表达，可能参与弥漫大 B 细胞淋巴瘤的免疫逃逸相关。IDO 高表达与弥漫大 B 细胞淋巴瘤疾病进展、疗效及预后不良相关，提示 IDO 可能成为弥漫大 B 细胞淋巴瘤患者的独立预后因子及新的治疗靶点。

Expression of IDO in diffuse large B - cell lymphoma and its clinical significance

Objective:To investigate the expression and significance of IDO in diffuse large B - cell lymphoma. Methods:Total of 63 cases paraffin blocks were selected and devided into experiment group(41 cases DLBCL)and control(22 case reactive hyperplasia). Immunohistochemical method was used to detect IDO expression levels and their relationships with clinical pathological characteristics were analyzed. Results:The positive expression rate of IDO in DLBCL was 56. 1% ,higher than reactive lymphoid hyperplasia group 22. 7% ,P = 0. 011. The expression of IDO related with Hans type and B symptoms,P = 0. 000,0. 035. Expression level of IDO was not related with age,gender, stage,number of extranodal involvement,IPI,ECOG and LDH of patients,there were no significant relationship,P﹥ 0. 05. Short - term efficacy was related with expression levels of IDO in DLBCL,P = 0. 001. Log - rank univariate survival analysis showed that expression of IDO,Hans type,B symptoms and IPI were statistically significant,P =0. 009,0. 003,0. 000,0. 030. But by COX multivariate survival analysis,only expression level of IDO had a statistical significance,P = 0. 024. Conclusion:IDO was highly expressed in DLBCL,which suggested that it could be involved with immune evasion from related lymphoma. The high expression of IDO was associated with diffuse large B - cell lymphoma progression,IDO can be an independent prognosis factor and new therapeutic target for diffuse large B -cell lymphoma patients.