上海交通大学学报（医学版）

上海交通大学学报（医学版）

• 论著（临床研究） • 上一篇    下一篇

198例弥漫大B细胞淋巴瘤临床特征及预后因素分析

徐海燕1，张凤春1,2，林玉梅3   

  1. 1.上海交通大学医学院附属苏州九龙医院血液肿瘤科， 苏州 215021； 2.上海交通大学医学院附属瑞金医院肿瘤科， 上海 200025； 3.吉林大学中日联谊医院肿瘤血液科， 长春 130033
  • 出版日期:2014-11-28 发布日期:2014-12-02
  • 作者简介:徐海燕（1979—），女，主治医师，硕士; 电子信箱: xuhaiyan0630@163.com。

Analysis of clinical characteristics of 198 cases of diffuse large B cell lymphoma and affecting factors of prognosis

XU Hai-yan1, ZHANG Feng-chun1,2, LIN Yu-mei3   

  1. 1.Department of Haematological Oncology, Kowloon Hospital, Shanghai Jiao Tong University School of Medicine, Suzhou 215021, China; 2.Department of Oncology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; 3.Department of Oncology, China-Japan Union Hospital of Jilin University, Changchun 130033, China
  • Online:2014-11-28 Published:2014-12-02

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摘要：

目的 探讨弥漫大B细胞淋巴瘤（DLBCL）的临床特征及预后影响因素。方法 以198例初诊DLBCL患者为研究对象，对基本临床特征、免疫学亚型、CD5、Bcl-2、Ki-67表达情况进行分析，确定相关因素与预后的关系。结果 161例行免疫学亚型检测,非生发中心样B细胞(non-GCB)型发病率（67.08%）显著高于生发中心样B细胞(GCB)型（32.92%）。134例行Bcl-2检测，阳性表达率为73.88%。84例行CD5检测，阳性表达率为19.05%。165例行Ki-67检测，其中有92.73%的患者Ki-67表达>50%。GCB型与non-GCB型患者在相关临床特征及肿瘤细胞CD5、Bcl-2、Ki-67表达方面进行比较，差异均无统计学意义（P>0.05）。年龄、B组症状、PS评分、临床分期、乳酸脱氢酶（LDH）水平、国际预后指数(IPI)、免疫学亚型、CD5及是否应用利妥昔单抗均影响DLBCL患者的生存时间。PS评分、IPI、免疫学亚型、是否应用利妥昔单抗治疗是影响DLBCL预后的独立因素。结论 DLBCL肿瘤细胞来源与临床特征无相关性；PS评分、IPI、免疫学亚型及是否应用利妥昔单抗治疗是影响DLBCL患者预后的独立因素。

关键词: 弥漫大B细胞淋巴瘤, 临床特征, 预后

Abstract:

Objective To investigate the clinical characteristics of diffuse large B cell lymphoma (DLBCL) and affecting factors of the prognosis. Methods A total of 198 patients initially diagnosed as DLBCL were selected. The general clinical characteristics, immunological subtypes, and expressions of CD5, Bcl-2, and Ki-67 were analyzed to determine the relationship of relevant factors and prognosis. Results Among 161 patients received immunological detection, the incidence of non-germinal center B cell (non-GCB) type DLBCL (67.08%) was significantly higher than that of germinal center B cell (GCB) type DLBCL (32.92%). Positive expression rate of Bcl-2 in 134 patients was 73.88%, while positive expression rate of CD5 in 84 patients was 19.05%. The Ki-67 expression of 92.73% of 165 patients was higher than 50%. The differences of clinical characteristics and expressions of CD5, Bcl-2, and Ki-67 of patients with GCB type DLBCL and non-GCB type DLBCL were not statistically significant (P>0.05). The survival time of patients with DLBCL was affected by the age, B symptom, PS score, clinical stage, lactate dehydrogenase (LDH) level, international prognostic index (IPI), immunological subtype, CD5, and treatment by rituximab. PS score, IPI, immunological subtype, and treatment by rituximab were independent factors that affected the prognosis of DLBCL. Conclusion The origin of DLBCL tumor cells has no correlation with clinical characteristics. PS score, IPI, immunological subtype, and treatment by rituximab are independent factors that affect the prognosis of patients with DLBCL.

Key words: diffuse large B cell lymphoma, clinical characteristics, prognosis