外周T细胞淋巴瘤-非特指型中的临床病理预后模型的探讨

Investigate of Clinical-Pathology Prognosis Model in Nodal Peripheral T-cell Lymphama-Unspecified

目的：探讨外周T细胞淋巴瘤-非特指型（PTCL-U）的临床病理预后模型。方法：应用免疫组化的方法检测2005-05/2008-05 55例经病理确诊的PTCL-U患者的病理组织的NF-κB/p50、P-gp170、GST-π、TOPO、Ki-67的表达情况,结合国际预后指数（IPI）分析临床病理预后因子与治疗效果、预后的关系。结果：本组55例患者中NF-κB/p50、P-gp170糖蛋白、GST-π、TOPO的表达阳性率分别为21.8%（12/55）、60.0%（33/55）、50.9%（28/55）和54.5%（30/55）。Ki-67的表达阳性率在5%~90%之间,中位的百分率为65%。NF-κB/p50阳性组,耐药阳性组,Ki-67高表达（≥65%）组与对照组相比较首程治疗完全缓解率无显著差异。本文提出了将NF-κB/p50阳性、MDR阳性（本文定义）和Ki-67高表达分别赋值1分,结合IPI5分的共计8分的临床病理预后模型（CPPI）。≥4分为高危组,〈4分为低危组,根据CPPI评分的低、高危组间首程治疗完全缓解率、总的生存率间的差异显著（P=0.014 6;P=0.000 0）。多因素生存分析显示,CPPI评分（P=0.034）是PTCL-U的独立预后因素。结论：临床病理预后模型（CPPI）能够在一定程度上预测PTCL-U对化疗的反应性和预后。

Objective：To investigate the clinical pathology prognosis model in peripheral T-cell lymphomas-unspecified（PTCL-U）.Methods：From May 2005 to May 2008,55 patients with PTCL-U were detected the expression of NF-κB/p50、P-gp170、GST-π、TOPOⅡ、Ki-67 by immunohistochemistry and analyzed correlation between them and PTCL-U s treatment effectiveness and prognosis.Results：21.8%,60.0%,50.9%,54.5% patients in our group were respectively positive for NF-κB/p50,P-glucoprotein 170,GST-π,TOPOⅡexpression. Exprssion of Ki-67 had a wide rangeof distribution from 5% to 95%.The media percentage was 65%. Complete remission rate in first line treatment was no significant difference between positive groups of NF-κB/p50, drug resistance and high expression of Ki 67 and their control groups, Suggested NF κB/p50 positive and high expression of Ki-67 as 1 score,combinated with Inrenational prognosis index （IPI） 5 seore We proposed clinical-pathology prognosis index （CPPI） which amount to 8 score. High risk group were≥4 seore.low risk group were %4 score. The difference of complete remission rate in first line treatment and overall survival rate was significant between high and low risk groups distinguished by our CPPI（P=0. 014 6;P=0. 000 0）. Multivariate analysis showed CPPI（P= 0. 044） were independent poor prognostic factor for PT- CI, U. Conclusion：At a certain extent, CPPI is able to predict response of chemotherapy and prognosis in PTCL-U.