免疫学分型在判定弥漫性大B细胞淋巴瘤预后中的临床意义

Clinical significance of immunological phenotype in predicting prognosis of diffuse large B-cell lymphoma

目的：探讨免疫学分型生发中心B细胞（GCB）亚型和非生发中心B细胞（NGCB）亚型在弥漫性大B细胞淋巴瘤（DLBCL）预后判定中的临床意义。方法：61例DLBCL患者中GCB亚型18例，NGCB亚型43例，分析不同临床特征[年龄、性别、民族、临床分期和国际预后指数（IPI）评分]患者中GCB、NGCB亚型的分布情况。结果：Ⅰ＋Ⅱ期、Ⅲ＋Ⅳ期患者GCB、NGCB亚型分别为77．8％、41．9%；22．2％、58．1％，两者差异有统计学学意义（P〈0．05）；IPI评分0～2分、3～5分，患者GCB、NGCB亚型分别为83．3％、41．9；16．7％、58．1％，两者差异有统计学意义（P〈0．05）；汉族、少数民族患者NGCB和GCB亚型分别占72．1％、38．9％；27．9%、61．1％，差异有统计学意义（P〈0．05）。结论：DLBCL中的两种免疫学亚型GCB和NGCB可能与患者病情进展、恶性程度有关，可作为判断预后的一种模式。

Objective： To explore clinical significance of immunological phenotype in predicting prognosis of diffuse large B-cell lymphoma （DLBCL）. Methods： GCB phenotype included 18 cases, and NGCB phenotype included 43 cases in 61 cases with DLBCL. We analysed the disposition of the two phenotypes in the patients with different clinical feature （the patients＇age, gender, nation, Ann arbor clinical stage, and IPI score）. Results： Ⅰ ＋ Ⅲ stage and Ⅲ ＋Ⅳ stage significantly accounted 77. 8%, 41. 9% and 22. 2%, 58.1% in GCB and NGCB phenotype of the cases （P d0.05 ） ; 0～2 score and 3～5 score significantly accounted 83.3%, 41.9% and 16.7%, 58. 1% in GCB and NGCB phenotype of these cases （Pal0.05）. Han people and minority significantly accounted 72. 1%, 38.9% and 27. 9%, 61. 1% in GCB and NGCB phenotype of the cases respectively （P 〈0.05 ）. Conclusions： The two immunological phenotypes of DL- BCL （GCB and NGCB phenotype） were probably correlated with clinical progression and malignancy. It may become a pattern of predicting prognosis.