摘要
目的比较弥漫大B细胞淋巴瘤(DLBCL)在Hans、Choi及Tally免疫学分型中不同免疫亚型患者接受不同治疗方案的生存差异,探讨3种免疫分型法评价DLBCL患者预后的价值。方法收集100例初治DLBCL患者的病例资料,分为化疗组(CHOP)及免疫化疗组(R-CHOP),对所有患者的病理组织石蜡切片进行免疫组化染色,用Hans、Choi和Tally 3种分型法进行免疫学分型。采用Kaplan-Meier法进行生存分析,生存曲线比较采用Log-rank检验。结果 3种分型结果得到的生发中心B细胞型(GCB型)均低于非生发中心B细胞型(Non-GCB型)/活化B细胞型(ABC型)。Hans分型中,化疗组中GCB型预后好于Non-GCB型,5年总生存(0S)率差异有统计学意义(P=0.0493);而免疫化疗组中GCB型和Non-GCB型的5年OS率差异无统计学意义(P=0.1441)。而在Choi和Tally分型中,无论化疗组还是免疫化疗组,GCB型的预后均好于ABC型/Non-GCB型,两者的5年OS率差异均有统计学意义(P<0.05)。结论 Hans分型用于预后评估具有一定的局限性,在免疫化疗时代DLBCL患者可能并不适用Hans分型来判断预后,而Choi及Tally分型更具有预后判断价值,仍需进一步扩大样本研究。
Objective To compare the survival of diffuse large B-cell lymphoma （DLBCL） patients with different therapeutic regimens and different immunological subtypes by Hans,Choi and Tally immunohistochemical stain algorithms,and investigate the prognostic value of the three algorithms,try to look for the most appropriate algorithms for Chinese patients with DLBCL. Methods The data of 100 initial DLBCL patients in our hospital were retrospectively analyze. All patients were divided into chemotherapy （CHOP） group and immune chemotherapy （R-CHOP） group. Immunohistochemical staining was performed. The phenotypic classifications were assessed according to the standard of Hans、Chan and Tally algorithms. Kaplan-Meier method was used for survival analysis,and the survival curve was compared by Log-rank test. Results The prevalence of germinal center B-cell-like（GCB） subtype was lower than that of Non-GCB/activated B-cell-like （ABC） subtypes as classified by whichever algorithms. For Hans algorithm,the 5-year overall survival （OS） rate of the GCB subtype patients in the CHOP group was significantly higher than that of the Non-GCB subtype （P=0.0493）,while there was no significant difference between GCB and Non-GCB subtypes patients in the R-CHOP group （P=0.1441）. However,for Choi and Tally algorithm,the 5-year OS rate of the GCB subtype patients was significantly higher than that of the Non-GCB subtype whichever in CHOP or R-CHOP group（P〈0.05）. Conclusion The prognostic value of Hans algorithm is limitated.ln the era of immuno-chemotherapy, DLBCL patients may not be suitable for Hans algorithm to evaluate prognosis. Moreover,Choi algorithm and Tally algorithm are more valuable to predict prognosis,so it is necessary to further study.
作者
黄燕
章玉英
钟赟
彭志强
双跃荣
HUANG Yan;ZHANG Yuying;ZHONG Yun(Jiangxi Cancer Hospital.Nanchang,330029,China)
出处
《江西医药》
CAS
2018年第8期788-791,817,共5页
Jiangxi Medical Journal
基金
江西省卫生计生委科技计划项目
编号20165416
关键词
淋巴瘤
大B细胞
弥漫性
免疫分型
预后
Lymphoma
Large B-cell
Diffuse
Immunophenotyping
Prognosis
