Expression of BAFF-R, but not BAFF, is an independent prognostic factor in diffuse large B-cell lymphoma patients treated with R-CHOP
Expression of BAFF-R, but not BAFF, is an independent prognostic factor in diffuse large B-cell lymphoma patients treated with R-CHOP
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BAFF-R（而非 BAFF）的表达是接受 R-CHOP 治疗的弥漫性大 B 细胞淋巴瘤患者的独立预后因素
DOI：
10.1007/s00277-015-2490-0
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发表时间：
2015-11-01
影响因子：
3.5
通讯作者：
Li, Zhi-Ming
中科院分区：
文献类型：
--
作者：
Wang, Yu;Li, Ya-Jun;Li, Zhi-Ming
B 细胞激活因子 (BAFF) 和 BAFF 受体 (BAFF-R) 在恶性 B 细胞的进展中发挥着至关重要的作用。本研究的目的是评估 BAFF 和 BAFF-R 在弥漫性大 B 细胞淋巴瘤 (DLBCL) 中的表达谱及其临床意义。通过免疫组织化学检查 136 例新诊断 DLBCL 患者的石蜡包埋标本，这些患者接受利妥昔单抗加环磷酰胺、阿霉素、长春新碱和泼尼松化疗 (R-CHOP) 治疗，以了解 BAFF 和 BAFF-R 的表达情况。 BAFF 和 BAFF-R 分别在 72.1% (98/136) 和 47.1% (64/136) 的 DLBCL 组织中表达。 BAFF-R 阴性表达与血清乳酸脱氢酶 (LDH) 水平升高 (P= 0.036)、国际预后指数 (IPI) 评分为 2 或更高 (P< 0.001) 以及修订后的 IPI (R-IPI) 风险评分较差 (P= 0.043) 显着相关。 BAFF-R 表达阳性的患者 R-CHOP 后的完全缓解率高于 BAFF-R 表达阴性的患者（73.4 vs. 56.9%，P= 0.045）。 BAFF-R 的阴性表达（而非 BAFF 的阴性表达）与较差的无进展生存期 (PFS;P= 0.020) 和总生存期 (OS;P= 0.028) 显着相关。在多变量分析中，只有阴性 BAFF-R 表达与较差的 PFS 和 OS 相关（分别为 P= 0.049 和 0.040）。总而言之，我们的结果表明，大多数和大约一半的 DLBCL 患者的 BAFF 和 BAFF-R 分别呈阳性。 BAFF-R 的阴性表达（而非 BAFF 的阴性表达）可能是接受标准 R-CHOP 治疗的 DLBCL 患者 PFS 和 OS 的独立危险因素。
B-cell activating factor (BAFF) and BAFF-receptor (BAFF-R) play crucial roles in the progression of malignant B-cells. The aim of the present study was to evaluate the expression profiles and the clinical significance of BAFF and BAFF-R in diffuse large B-cell lymphoma (DLBCL). Paraffin-embedded specimens from 136 patients with newly diagnosed DLBCL, treated with rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone chemotherapy (R-CHOP), were examined for BAFF and BAFF-R expression by immunohistochemistry. BAFF and BAFF-R were expressed in 72.1 % (98/136) and 47.1 % (64/136) of the DLBCL tissues, respectively. Negative BAFF-R expression was significantly correlated with elevated serum lactate dehydrogenase (LDH) levels (P= 0.036), an International Prognostic Index (IPI) score of 2 or higher (P< 0.001), and a poor revised IPI (R-IPI) risk score (P= 0.043). The complete response rate after R-CHOP was higher in patients with positive BAFF-R expression than in those with negative BAFF-R expression (73.4 vs. 56.9 %,P= 0.045). Negative expression of BAFF-R, but not of BAFF, was significantly associated with inferior progression-free survival (PFS;P= 0.020) and overall survival (OS;P= 0.028). Only negative BAFF-R expression was correlated with inferior PFS and OS in multivariate analysis (P= 0.049 and 0.040, respectively). Taken together, our results showed that the majority and approximate one-half of patients with DLBCL were positive for BAFF and BAFF-R, respectively. Negative expression of BAFF-R, but not of BAFF, could be an independent risk factor for PFS and OS in patients with DLBCL treated with standard R-CHOP.