IDO表达对CD20+弥漫大B细胞淋巴瘤RCHOP方案治疗预后的评估价值分析

Evaluation value of IDO in the prognosis of CD20+ diffuse large B-cell lymphoma treatment with RCHOP regimen

目的:分析吲哚胺2,3双加氧酶(indoleamine 2,3-dioxygenase,IDO)表达对CD20+弥漫大B细胞淋巴瘤(DLBCL)RCHOP方案治疗预后的评估价值。方法:收集本院2015年2月~2017年8月确诊为CD20+DLBCL患者的癌组织蜡块92例为病例组,另选取同期在本院接受淋巴结探查切除术治疗,病理诊断为淋巴结反应性增生的标本45例作为对照组。采用Envision法检测两组IDO表达情况;收集统计病例组患者临床信息,包括性别、年龄、Hans分型、Ann Arbor分期、血清LDH水平、有无B症状、国际预后指数(IPI)、体力状况评分(ECOG)及临床疗效,对病例组患者随访3年,记录患者生存情况。结果:IDO在病例组患者癌组织中的阳性表达率为53.26%,显著高于对照组的24.44%,差异有统计学意义。在不同性别、年龄、血清LDH水平、结外数目、IPI评分及ECOG评分的CD20+DLBCL患者中,IDO在CD20+DLBCL癌组织中的表达差异均无统计学意义。当患者Hans分型为Non-GCB、临床分期较高、有B症状出现时,IDO阳性表达率明显增高,差异均有统计学意义。PR+CR组患者的IDO阳性表达率为34.69%,显著低于PD+SD组的65.31%,差异均有统计学意义。本组92例CD20+DLBCL患者均获随访,随访率100%。建立Kaplan-Meier生存模型曲线,显示IDO阳性表达者的中位生存期为20个月,IDO阴性表达者的中位生存期36个月,采用Log-rank检验显示,IDO表达阴性患者组生存率高于阳性患者组,差异有统计学意义。结论:IDO在CD20+DLBCL癌组织中高表达,且与疾病进展、临床疗效及预后情况相关。

Objective To analyze the evaluation value of indoleamine 2,3-dioxygenase(IDO)in prognosis of CD20+diffuse large B-cell lymphoma(DLBCL)treatment with RCHOP regimen.Methods The cancer tissue waxes from 92 patients with CD20+DLBCL confirmed in the hospital from February 2015 to August 2017 were collected as case group,while specimens from other 45 patients who underwent lymph node exploration resection and were pathologically diagnosed with lymph node reactive hyperplasia in the hospital during the same period were collected as control group.IDO in both groups was detected by Envision method.The clinical data of patients in case group were collected and statistically analyzed,including gender,age,Hans classifications,Ann Arbor staging,level of serum LDH,presence or absence of B symptoms,international prognostic index(IPI),eastern cooperative oncology group(ECOG)and clinical curative effect.The patients in case group were followed up for 3 years to record their survival.Results The positive expression rate of IDO in cancer tissues in case group was significantly higher than that in control group(53.26%vs 24.44%).The difference in the expression of IDO in cancer tissues among CD20+DLBCL patients with different gender,age,level of serum LDH,extranodal number,IPI and ECOG scores was not statistically significant.The positive expression rate of IDO was significantly higher in patient with Hans classification of Non-GCB,high clinical staging and B symptoms.The positive expression rate of IDO in PR+CR group was significantly lower than that in PD+SD group(34.69%vs 65.31%).All the 92 CD20+DLBCL patients were followed up,with follow-up rate of 100%.The established Kaplan-Meier survival model curve showed that median survival time in IDO-positive and IDO-negative patients was 20 months and 36 months,respectively.Log-rank test showed that survival rate in IDO-negative group was higher than that in positive group.Conclusion IDO is highly expressed in cancer tissues of CD20+DLBCL,which is related to disease progression,clinical curative effect and prognosis.