非霍奇金淋巴瘤预后相关因素研究

Prognostic significance of bcl-2,p53,CD44 expression in non-Hodgkin's lymphoma

目的探讨非霍奇金淋巴瘤(NHL)的中bcl-2、CD44、p53的表达对患者预后的影响。方法用免疫组化方法检测96例NHL石蜡切中bcl-2、CD44、p53的表达,分析其表达水平对患者生存率和临床特征的影响。结果全组患者4年生存率(4yOS)40.73%,中位生存期(mST)40.0个月。惰性NHL、侵袭性NHL4yOS分别为58.46%、35.49%,获CR、PR者4yOS分别为48.4%、42.6%,治疗无效者4yOS为14.1%。B-NHL和T-NHL4yOS分别为57.12%、7.01%,bcl-2阴性组和阳性组4yOS分别为48.04%、20.88%;p53阴性组4yOS明显高于p53阳性组,分别为48.22%、21.60%;CD44阴性4yOS明显高于CD44阳性组,P均<0.05。T/B细胞表型、bcl-2和p53是独立影响因素。p53和bcl-2阳性表达者治疗缓解率低,CD44与肿瘤分期和结外侵犯相关。结论T细胞型、bcl-2、CD44、p53蛋白的高表达对患者生存有显著的不良影响,T/B细胞表型、p53、bcl-2作为独立的预后分子标志,是IPI的必要补充。

Objective to explore and analyse elinical and molecular prognostic faetors in NHL. Methods Paraffin-embedded specimens obstained from 96 patients with NHL were detected immunohistochemically using monoelonal antibodies for bcl-2, p53 and CD44. We explored the prognostic value of the molecular markers ,clinical factors anti the interaetion among these factors. Results The molecular markers including p53, bcl-2,CD44 and T/B-cell phenotype showed a significant prognostic effect on survival in univariate analysis. T/B-cell phenotype, p53, bel-2 were independ prognosis factor in multivariate analysis. Expression of p53 and bel-2 often have poor treatment response. CD44 expression was significantly correlated with advanced stage and the number of extronodal lesions. Conclusion T/B-cell phenotype, Expression of CD44, p53 and bcl-2 were disadvantageous molecular prognosis factors. IPI is a very useful prognostic factor for NHL. p53 and bcl-2 can he used as complement biological factor of IPl for predicting the prognosis of NHL.