[Effect of Different Protein Expression and Clinical Features on the Prognosis of Patients with Diffuse Large B-Cell Lymphoma]

Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2019 Oct;27(5):1490-1496. doi: 10.19746/j.cnki.issn.1009-2137.2019.05.021.
[Article in Chinese]

Abstract

Objective: To investigate the efficacy of multiple protein expressions and clinical features on the threapeutic effect and prognosis of patients with newly diagnosed diffuse large B-cell lymphoma (DLBCL).

Methods: The clinical data of 68 DLBCL patients were collected and analyzed retrospectively. The clinical staging was performed according to Ann Arbor staging; the risk grading was performed by IPI index; the DLBCL typing (germinal center and non-germinal center) was performed according to B cell source; the expression of Ki67,BCL-2, BCL-6, C-MYC, MUM1 and CD10 protein was detected by immunohistochemistry method; the patients were divided into R-CHOP group(50 cases) and CHOP group(18 cases) according to chemotherapy regimen of using rituximab or not; finally, the related factors affecting the prognosis of patients(PFS and OS) were analysed statistically by using SPSS 22.0 software according to sex, age, erythrocyte sedimentation rate (ESR), lactate dehydrogenase(LDH) and use of rituximab or no, as well as the above-mentioned clinical indicators.

Results: IPI grade high-risk, elevated LDH, positive expression of BCL-2 protein and negative expression of BCL-6 protein were independent prognostic factors for progression-free survival (PFS); elevated LDH and negative expression of BCL-6 protein were independent prognostic factors for overall survival time (OS); multivariate analysis showed that elevated LDH and positive expression of BCL-2 protein were independent prognostic factors for progression-free survival (PFS). The overall survival time (OS) associated with ESR, IPI classification and BCL-6 protein expression.

Conclusion: The expression of BCL-2 and BCL-6 protein and some clinical features can be used as predictors of clinical efficacy for DLBCL. Choosing the treatment regimen combined with ritu-ximab can further improve the survival and prognosis of DLBCL patients.

题目: 不同蛋白表达及临床特征对弥漫大B细胞淋巴瘤患者预后的影响.

目的: 探讨多种蛋白表达及临床特征对初诊弥漫大B细胞淋巴瘤(DLBCL)患者治疗效果的影响.

方法: 回顾性分析我院68例初诊DLBCL患者的临床资料,根据Ann Arbor进行临床分期, IPI指数进行危险分级,依B细胞来源分为生发中心来源及非生发中心来源,免疫组织化学检测Ki67、BCL-2、BCL-6、C-MYC、MUM1、CD10等蛋白的表达,根据化疗方案将患者分为R-CHOP组(50例)和CHOP样组(18例),最后根据性别、年龄、红细胞沉降率(ESR)、血清乳酸脱氢酶(LDH)、是否使用利妥昔单抗以及上述临床指标,应用SPSS 22.0软件进行统计学分析影响初诊DLBCL患者的预后因素.

结果: IPI分级为高中-高危、LDH升高、BCL-2蛋白阳性表达、BCL-6蛋白阴性表达为无进展生存期(PFS)的独立影响因素;LDH升高和BCL-6蛋白阴性表达为总生存时间(OS)的独立预后影响因素;多因素分析显示,LDH升高、BCL-2蛋白阳性表达为无进展生存期(PFS)的影响因素,而总生存时间(OS)与ESR、IPI分级、BCL-6蛋白表达有关.

结论: BCL-2、BCL-6蛋白表达及部分临床特征可作为DLBCL临床疗效的预测指标,选择联合利妥昔单抗的治疗方案,可进一步改善DLBCL患者的生存预后.

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols
  • Cyclophosphamide
  • Doxorubicin
  • Humans
  • Lymphoma, Large B-Cell, Diffuse*
  • Prognosis
  • Proto-Oncogene Proteins c-bcl-6
  • Retrospective Studies

Substances

  • Proto-Oncogene Proteins c-bcl-6
  • Doxorubicin
  • Cyclophosphamide