核面积大小、DNA指数及p53对大B细胞淋巴瘤恶性程度判断价值

Significance of the Nuclear Size?DNA index and p53 to the Diffuse Large B-cell Lymphoma

目的 探讨核面积大小、DNA指数及p5 3对弥漫性大B细胞淋巴瘤的恶性程度判断的临床意义。方法 应用图像分析技术 ,对经过病理检查确诊的 62例弥漫性大B细胞性淋巴瘤的瘤细胞细胞核大小进行定量检测 ,应用流式细胞分析技术检测细胞核DNA的含量 ,算出DI值。核大小以面积值来衡量 ,以 41.8μm2 为界限 ,<41.8μm2 为 1级 ,≥ 41.8μm2 为 2级。同时应用免疫组化S P法 ,对弥漫性大B细胞淋巴瘤作预后相关指标 p5 3进行标记 ,计算阳性率。 结果 表达CD2 0阳性弥漫性大B细胞性淋巴瘤 62例 ,核面积 1级者 42例 ,均值为 ( 3 6.9± 4.6) μm2 ,核面积 2级者 2 0例 ,均值为 ( 4 8.6± 6.7) μm2 ,两者有非常显著性差异 (P <0 .0 1)。核面积 1级者DI值为 1.16± 0 .16,核面积 2级者DI值为 1.98± 0 .12 ,两者比较有显著性差异 (P <0 .0 5 ,t =2 .0 7) ;核面积 1级者 p5 3阳性表达率为 2 3 .8% ( 10 /4 2 ) ,核面积 2级者 p5 3阳性表达率为 5 0 .0 % ( 10 /2 0 ) ,两者p5 3阳性表达率比较有显著性差异 (P <0 .0 5 ,χ2 =4.2 6) ;两者IPI预后指数恶性危险度的级别 (高、中、低 )也有显著性差异 (P <0 .0 5 ,χ2 =6.62 )。结论 核面积越大 ,核DNA含量越高 ,p5 3阳性表达率越高 ,肿瘤恶性程度越高 ,预后越差 。

Objective To investigate the significance of the nuclear size?DNA index(DI) and p53 in the determination of the malignancy of Diffuse B-cell Lymphoma(DLBCL).Methods The nuclear size was measured by image analysis technique in 62 cases with pathological documented DLBCL.The DNA content was tested by flow cytometer technique and the DI was caculated.The nuclear size was graded as I when the nuclear surface area <41.8 μm^2 and as Ⅱ when the nuclear surface area ≥41.8 μm^2.Immunohistochemical method was used to determine the expression of p53.Results 42 cases had grade I nuclear size with an average of ((36.9)±4.6) μ m^2.20 cases had grade Ⅱ nuclear size with an average of (48.6±6.7) μm^2 showing a significant difference between the two groups(P<0.01).DI was 1.16±0.16 for patients with grade I nuclear size and 1.98±0.12 for patients with grade Ⅱ nuclear size,showing a significant difference between the two groups(P<(0.05)).The positive rate of p53 was 23.8%(10/42) for patients with grade I nuclear size and 50.0%(10/20) for patients with grade Ⅱ nuclear size,showing a significant difference between the two groups(P<0.05).The IPI was also markedly difference between the two groups with different nuclear size(P<0.05).Conclusion The malignance of the DLBCL gets higher when the patient has a big nuclear size and a high expression rate of p53.The nuclear size,combined with IPI,is useful to determine the malignancy of DLBCL.