目的探索血清外泌体miR-451a在弥漫大B细胞淋巴瘤(diffuse large B cell lymphoma,DLBCL)中的水平及其在治疗监测中的价值。方法本研究共纳入56例DLBCL患者,56例健康对照者。收集新发DLBCL患者治疗前、化疗2~4疗程及化疗结束后血清样本...目的探索血清外泌体miR-451a在弥漫大B细胞淋巴瘤(diffuse large B cell lymphoma,DLBCL)中的水平及其在治疗监测中的价值。方法本研究共纳入56例DLBCL患者,56例健康对照者。收集新发DLBCL患者治疗前、化疗2~4疗程及化疗结束后血清样本,并同时收集健康人血液标本,提取血清中的外泌体RNA,并进行实时荧光定量PCR(quantitative real time polymerase chain reaction,qRT-PCR),用受试者工作特征(receive operator characteristic,ROC)曲线判定miR-451a的诊断效能,用各时点收集的血清样本动态分析血清外泌体miR-451a水平与化疗效果之间的关系。结果 56例DLBCL患者与56例健康对照者相比,DLBCL患者血清外泌体miR-451a水平下降(P<0.000 1),在两组受试者间用miR-451a诊断DLBCL的曲线下面积(AUC)为0.737(95%CI0.645~0.816)。在随访到的43例DLBCL患者中,化疗后获得完全缓解或者部分缓解的患者其血清外泌体miR-451a水平较化疗前有所上升(P<0.05),与配对的健康人水平差异无统计学意义(P>0.05);化疗后未获得缓解的患者,其血清外泌体miR-451a水平较化疗前无明显变化(P>0.05),且仍然低于配对的健康人水平(P<0.05);化疗完成后在未缓解者与缓解者之间进行鉴别,血清miR-451a的AUC为0.867(95%CI 0.728~0.951)。结论血清外泌体miR-451a水平动态监测有助于DLBCL化疗过程中的疗效(是否缓解)判断。展开更多
目的分析初治原发性胃弥漫大B细胞淋巴瘤（primary gastric diffuse large B cell lymphoma,PGDLBCL）的临床特征、诊断、治疗和预后,探讨利妥昔单抗的作用。方法回顾性分析2005年1月至2012年5月军事医学科学院附属医院收治的26例初治PG...目的分析初治原发性胃弥漫大B细胞淋巴瘤（primary gastric diffuse large B cell lymphoma,PGDLBCL）的临床特征、诊断、治疗和预后,探讨利妥昔单抗的作用。方法回顾性分析2005年1月至2012年5月军事医学科学院附属医院收治的26例初治PGDLBCL患者的临床特征、诊断、治疗、近期和远期疗效,以及不同治疗方法和预后因素与疗效的关系。结果纳入26例PGDLBCL患者,男性14例,女性12例,中位年龄50.1岁,最常见症状为腹痛。全组患者采用化疗联合放疗的综合治疗模式,分为单纯CHOP组（n=9）和RCHOP组（n=17）,CR率分别为55.56%（5/9）和50%（8/16）,两组差异无显著性意义。中位随访40个月（3～84个月）,全组5年无进展生存期为60.3%,总生存期74.4%。其中RCHOP组分别为58.9%和84.6%,CHOP组为66.7%和66.7%,RCHOP组优于CHOP组,但无统计学差异。单因素分析显示Lugano分期和IPI评分显著影响预后。结论化疗可作为PGDLBCL的一线治疗,加用利妥昔单抗可能有利于提高远期生存率;临床分期和IPI评分是重要预后因素。展开更多
Objective: To explore the clinicobiologic features and outcomes of diffuse large B-cell lymphoma(DLBCL)patients in China according to the primary site.Methods: A total of 1,085 patients diagnosed with DLBCL in Nationa...Objective: To explore the clinicobiologic features and outcomes of diffuse large B-cell lymphoma(DLBCL)patients in China according to the primary site.Methods: A total of 1,085 patients diagnosed with DLBCL in National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College during a 6-year period were enrolled. Their clinical characteristics and outcomes were analyzed according to the primary site.Results: In the 1,085 patients, 679(62.6%) cases were nodal DLBCL(N-DLBCL) and 406 cases(37.4%) were extranodal DLBCL(EN-DLBCL). The most common sites of N-DLBCL were lymphonodus(64.8%), Waldeyer's ring(19.7%), mediastinum(12.8%) and spleen(2.7%), while in EN-DLBCL, stomach(22.4%), intestine(16.0%),nose and sinuses(8.9%), testis(8.4%), skin(7.9%), thyroid(6.9%), central nervous system(CNS)(6.4%), breast(5.7%), bone(3.4%), and salivary gland(2.7%) were most common. N-DLBCL patients tend to present B symptoms, bulky disease, and elevated LDH more often, while age >60 years, extranodal sites >1, Ann Arbor stage I or II, bone marrow involvement, and Ki-67 index >90% were usually seen in EN-DLBCL. The 5-year overall survival(OS) rate and progression-free survival(PFS) rate for all patients were 62.5% and 54.2%. The 5-year OS rate for patients with N-DLBCL and EN-DLBCL were 65.5% and 56.9%(P=0.008), and the 5-year PFS were57.0% and 49.0%(P=0.020). Waldeyer's ring originated DLBCL possessed the highest 5-year OS rate(83.6%) and PFS rate(76.9%) in N-DLBCL. The top five EN-DLBCL subtypes with favorable prognosis were stomach,breast, nose and sinuses, lung, salivary gland, with 5-year OS rate: 70.3%, 69.6%, 69.4%, 66.7% and 63.6%,respectively. While CNS, testis, oral cavity and kidney originated EN-DLBCL faced miserable prognosis, with 5-year OS rate of 26.9%, 38.2%, and 42.9%.Conclusions: In our study, primary sites were associated with clinical characteristics and outcomes. Compared with EN-DLBCL, N-DLBCL had better prognosis.展开更多
文摘目的探索血清外泌体miR-451a在弥漫大B细胞淋巴瘤(diffuse large B cell lymphoma,DLBCL)中的水平及其在治疗监测中的价值。方法本研究共纳入56例DLBCL患者,56例健康对照者。收集新发DLBCL患者治疗前、化疗2~4疗程及化疗结束后血清样本,并同时收集健康人血液标本,提取血清中的外泌体RNA,并进行实时荧光定量PCR(quantitative real time polymerase chain reaction,qRT-PCR),用受试者工作特征(receive operator characteristic,ROC)曲线判定miR-451a的诊断效能,用各时点收集的血清样本动态分析血清外泌体miR-451a水平与化疗效果之间的关系。结果 56例DLBCL患者与56例健康对照者相比,DLBCL患者血清外泌体miR-451a水平下降(P<0.000 1),在两组受试者间用miR-451a诊断DLBCL的曲线下面积(AUC)为0.737(95%CI0.645~0.816)。在随访到的43例DLBCL患者中,化疗后获得完全缓解或者部分缓解的患者其血清外泌体miR-451a水平较化疗前有所上升(P<0.05),与配对的健康人水平差异无统计学意义(P>0.05);化疗后未获得缓解的患者,其血清外泌体miR-451a水平较化疗前无明显变化(P>0.05),且仍然低于配对的健康人水平(P<0.05);化疗完成后在未缓解者与缓解者之间进行鉴别,血清miR-451a的AUC为0.867(95%CI 0.728~0.951)。结论血清外泌体miR-451a水平动态监测有助于DLBCL化疗过程中的疗效(是否缓解)判断。
文摘目的分析初治原发性胃弥漫大B细胞淋巴瘤（primary gastric diffuse large B cell lymphoma,PGDLBCL）的临床特征、诊断、治疗和预后,探讨利妥昔单抗的作用。方法回顾性分析2005年1月至2012年5月军事医学科学院附属医院收治的26例初治PGDLBCL患者的临床特征、诊断、治疗、近期和远期疗效,以及不同治疗方法和预后因素与疗效的关系。结果纳入26例PGDLBCL患者,男性14例,女性12例,中位年龄50.1岁,最常见症状为腹痛。全组患者采用化疗联合放疗的综合治疗模式,分为单纯CHOP组（n=9）和RCHOP组（n=17）,CR率分别为55.56%（5/9）和50%（8/16）,两组差异无显著性意义。中位随访40个月（3～84个月）,全组5年无进展生存期为60.3%,总生存期74.4%。其中RCHOP组分别为58.9%和84.6%,CHOP组为66.7%和66.7%,RCHOP组优于CHOP组,但无统计学差异。单因素分析显示Lugano分期和IPI评分显著影响预后。结论化疗可作为PGDLBCL的一线治疗,加用利妥昔单抗可能有利于提高远期生存率;临床分期和IPI评分是重要预后因素。
基金funded by grants from the National Science and Technology Support Program (No. 2014BAI09B12)Chinese Academy of Medical Sciences (CAMS) Innovation Fund for Medical Sciences (CIFMS) (No. 2016-I2M-1-001)
文摘Objective: To explore the clinicobiologic features and outcomes of diffuse large B-cell lymphoma(DLBCL)patients in China according to the primary site.Methods: A total of 1,085 patients diagnosed with DLBCL in National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College during a 6-year period were enrolled. Their clinical characteristics and outcomes were analyzed according to the primary site.Results: In the 1,085 patients, 679(62.6%) cases were nodal DLBCL(N-DLBCL) and 406 cases(37.4%) were extranodal DLBCL(EN-DLBCL). The most common sites of N-DLBCL were lymphonodus(64.8%), Waldeyer's ring(19.7%), mediastinum(12.8%) and spleen(2.7%), while in EN-DLBCL, stomach(22.4%), intestine(16.0%),nose and sinuses(8.9%), testis(8.4%), skin(7.9%), thyroid(6.9%), central nervous system(CNS)(6.4%), breast(5.7%), bone(3.4%), and salivary gland(2.7%) were most common. N-DLBCL patients tend to present B symptoms, bulky disease, and elevated LDH more often, while age >60 years, extranodal sites >1, Ann Arbor stage I or II, bone marrow involvement, and Ki-67 index >90% were usually seen in EN-DLBCL. The 5-year overall survival(OS) rate and progression-free survival(PFS) rate for all patients were 62.5% and 54.2%. The 5-year OS rate for patients with N-DLBCL and EN-DLBCL were 65.5% and 56.9%(P=0.008), and the 5-year PFS were57.0% and 49.0%(P=0.020). Waldeyer's ring originated DLBCL possessed the highest 5-year OS rate(83.6%) and PFS rate(76.9%) in N-DLBCL. The top five EN-DLBCL subtypes with favorable prognosis were stomach,breast, nose and sinuses, lung, salivary gland, with 5-year OS rate: 70.3%, 69.6%, 69.4%, 66.7% and 63.6%,respectively. While CNS, testis, oral cavity and kidney originated EN-DLBCL faced miserable prognosis, with 5-year OS rate of 26.9%, 38.2%, and 42.9%.Conclusions: In our study, primary sites were associated with clinical characteristics and outcomes. Compared with EN-DLBCL, N-DLBCL had better prognosis.
