细胞毒分子在原发结内的外周T细胞淋巴瘤非特指型中的表达及意义

Significance of cytotoxic molecule expression in nodal peripheral T-cell lymphoma-unspecified

目的:通过对外周T细胞淋巴瘤-非特指型(PTCL-U)患者病理组织蜡块细胞毒分子(CM)T细胞内抗原(TIA-1)和颗粒酶B(GB)的免疫组化检测,探讨CM在PTCL-U进一步分型中的作用及意义。方法:应用免疫组化的方法检测2005年1月～2008年1月51例经病理确诊的PTCL-U患者的TIA-1和GB的表达情况,并分析其与Ki-67、临床特征和治疗意义以及预后的关系。结果:本组51例患者中有33.3%(17/51)表达至少1个细胞毒分子。在CM阳性与阴性表达中,Ki-67高表达比例为88.2%vs.50.0%(P=0.0078),LDH升高比例为82.4%vs.52.9%(P=0.0406),出现B症状比例为70.6%vs.35.3%(P=0.0173),一般行为状态差(PS>2分)比例为64.7%vs.32.4%(P=0.0279);总的生存率经Log-rank检验CM阳性显著低于阴性(P=0.0015)。多因素生存分析显示,CM、一般行为状态差(PS>2分)和Ki-67高表达可以做为PTCL-U的独立预后因素。结论:细胞毒分子的表达不仅和PTCL-U预后差相关,而且作为细胞毒细胞的特异性标记在原发于结内的PTCL-U进一步分型中具有一定的作用。

Objective ： To study the expression of cytotoxic molecules （ CM ： TIA-1, granzyme B ） in peripheral T-cell lymphoma-unspecified（PTCL-U） and to investigate their significance in PTCL-U category. Methods：From January 2005 to January 2008, 51 patients were diagnosed PTCL-U in tangshan people＇s hospital and tangshan xiehe hospital, which were studied for the expression of the eytotoxic molecules（ TIA-1, granzyme B） by immunohistochemical staining. The relationship between CM and Ki-67, clinical charateristics, treatment response and prognosis was analysed. Results：Thirty-three percent（ 17/51 ） was positive for at least 1 C M, patients which CM-positive PTCL-U were significantly assoseiated with higher expression of Ki-67 （88. 2% vs. 50. 0% ,P = 0. 007 8 ） ,poor performance （64. 7% vs. 32. 4% ,P =0. 027 9） ,more frequent B-syndrome（70. 6% vs. 35.3% ,P =0. 017 3） , higher serum lactate dehydrogenase（LDH） level（82. 4% vs. 52.9% ,P = 0. 040 6）. Overall survival of CM-positive FFCL-U was significantly lower than that of CM-negative patients（ P = 0. 001 5 ）. Multivariate analysis showed CM,poor performance and higher Ki-67 was an independent prog nostic factor for PTCL-U. Conclusion ： Expression of CM in PTCL-U was not only related to poor prognosis, but also could play an important role in PTCL-U categorization.