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弥漫性大B 细胞型淋巴瘤73 例临床病理分析

Clinicopathologic Analysis of 73 Cases with Diffuse Large B Cell Lymphoma

  • 摘要: 目的 探讨CD10 、CD30 、CD138 、Bcl26 及Mum21/ IRF24 与弥漫性大B 细胞性淋巴瘤(DLBCL) 的分子亚型及预后的关系。方法 对73 例DLBCL 进行HE 及免疫组化染色、光镜观察,随访所有患者并分析临床资料。结果 单因素分析,Bcl26 和Mum21 的表达是影响生存的重要因素, P 值分别为0. 028和0. 001 。CD138 阳性可能提示患者预后不良。按Hans 分组标准将患者分为两组,GCB 型19 例 (26 %) ;non2GCB 型54 例(74 %), 两型预后差异无统计学意义。按Chang 标准分为4 组: A 组5 例 (6. 9 %) ;B 组29 例(39. 7 %) ;C 组29 例(39. 7 %) ;D 组10 例(13. 7 %) 。其中B 组患者预后相对较好,D 组患者最差,C 组预后介于两组之间。结论 DLBCL 中,Bcl26 、Mum21 阳性患者预后好;CD138 的表达可能提示预后不良。

     

    Abstract: Objective  To evaluate if using a panel of markers such as CD10, CD30, CD138, Bcl26 and Mum1/ IRF4 by immunohistochemist ry defines prognosis in patient s with diffuse large B2cell lymphoma (DLBCL) . Methods  Immunohistochemical stains for the above markers were performed on paraffin2em2 bedded tissues of 73 patient s consecutively diagnosed with DLBCL. Results  The univariate analysis dem2 onst rated that the expression of Bcl26 and Mum21 were significant prognosis factors, with P values of 0. 028 and 0. 001. CD138 ( P = 0. 210) may play an important role as a poor prognostic marker. Moreover, when the patient s were subdivided according to Hans, there is no difference between GCB (19 patient s, 26 %) and non2GCB(54 patient s, 74 %) in survival rate ( P = 0. 959) . Using the four group s classification of Chang, 5 patient s (6. 9 %) were subclassified as pattern A, 29 (39. 7 %) as B and C separately, and 10 (13. 7 %) as D. Among the four patterns, pattern B showed a better survival rate, pattern D had a signifi2 cantly lower survival rate, and pattern C is between the two groups. Conclusion  In the present study, the expression of Bcl26 and Mum21 were associated with particular clinicopathologic features and outcome, which were favourable prognostic factors. CD138 may play an important role as a poor prognostic marker.

     

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