Prognostic significance of immunohistochemical classification of diffuse large B-cell lymphoma
Prognostic significance of immunohistochemical classification of diffuse large B-cell lymphoma
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DOI：
10.1179/102453309x385205
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发表时间：
2009-04-01
期刊：
影响因子：
1.9
通讯作者：
Undar, Bulent
中科院分区：
文献类型：
--
作者：
Alacacioglu, Inci;Ozcan, Mehmet Ali;Undar, Bulent
目的：为探讨免疫组化染色CD 10、bcl-6、mum-1和bcl-2对DLBCL预后亚群的临床意义，我们对50例DLBCL患者进行了免疫组化分析。CD 10的表达与较好的OS相关（p=0.04），而mum-1的表达与较差的OS相关（p=0.009）。bcl-6（p=0.05）和bcl-2（p=0.3）表达与总生存期无显著性差异。以CD 10、mum-1、bcl-6为指标，将其分为生殖中心B细胞样（GCB）淋巴瘤（30%）和非GCB淋巴瘤（70%）。GCB组的OS和EFS（无事件生存期）更长（p=0.002），GCB组的5年OS为92%，而非GCB组仅为44%（p=0.02）。在IPI评分较低的患者中，GCB组的生存期也明显长于非GCB组（P=0.01）。结论：IPI评分较低的患者中，GCB组与非GCB组的生存期存在差异，提示预后分型在风险适应性治疗中的重要性。基于GCB和非GCB的免疫染色的分类可以使得能够在DLBCL中定义更准确的预后组。
Aim: To evaluate the clinical significance of immunoperoxidase staining for CD10, bcl-6, mum-1 and bcl-2 to subdivide DLBCL into prognostic subgroups, we analysed 50 DLBCL cases using immunohistochemical methods.Methods and results: Fifty DLBCL patients were evaluated retrospectively. The expression of CD10 was associated with better OS (p=0.04) whereas expression of mum-1 was associated with worse OS (p=0.009). There were no significance of OS in case of expression of bcl-6 (p=0.05) and bcl-2 (p=0.3). They were subclassified using CD10, mum-1, bcl-6 as germinal center B-cell like (GCB) lymphoma (30%) and non-GCB lymphoma (70%). The OS and EFS (event free survival) were longer in GCB group (p=0.002) and 5-year OS for GCB group was 92% compared with only 44% for the non-GCB group (p=0.02). The OS of the GCB group also was longer compared to that of the non-GCB group in low IPI subgroup (p=0.01).Conclusion: The existance of survival differences between GCB a non-GCB group also in the patients with low IPI score, showed the importance of prognostic classification in the risk-adaptive treatment approaches. The classification as GCB and non-GCB based immunostains may enable to define more accurate prognostic groups in DLBCL.