CD68阳性淋巴瘤相关巨噬细胞在滤泡性淋巴瘤间质中的密度及其临床意义的研究

Expression and Clinical Significance of Lymphoma-associated Macrophages(CD68 Positive Cells)in the Matrix of Follicular Lymphoma

目的:滤泡性淋巴瘤(FL)是最常见的惰性NHL,亦是一种异质性的疾病。FL的预后指标是临床上广泛应用的滤泡淋巴瘤国际预后指标(FLIPI),具有较高的准确性和简便性,但相同FLIPI的患者预后情况实际不尽相同,反映了FL异质性的特点,在相同的组织分类中存在遗传学和生物学特征不同的亚型。因此有必要寻找新的分子指标以期更准确地预测FL患者的预后。本研究旨在探讨淋巴瘤相关巨噬细胞(LAM)对FL预后判断的价值。方法:免疫组化二步法检测2002年2月至2006年11月间收治的48例初治FL患者组织中LAM的密度,分析其表达与患者临床特征、近期疗效及远期生存率的关系。结果:48例FL患者LAM低密度者38例(79.2%),高密度者10例(20.8%)。LAM密度与患者年龄、PS状态、血清LDH水平、分期等临床特征无关,与FLIPI评分也无相关性。LAM低密度组化疗疗效和高密度组相近。全组48例患者未达到中位生存期(MST),LAM低密度组MST优于高密度组(P=0.002)。多因素分析结果显示LAM与FL的预后无明显相关(P>0.05)。结论:LAM的高密度与FL的远期生存呈负相关。但由于本研究入组患者较少,随访时间短,未能达到统计学意义,值得进一步探讨。

Objective： To find new prognostic molecular markers for follicular lymphoma （ FL ） and to explore the role of lymphoma-associated macrophages （LAM） in predicting the prognosis of FL. Methods： The expression of LAM in 48 specimens of FL was detected by non-biotin HRP detection Immunohistochemistry method, and the correlations between LAM expression and patient characteristics, treatment response, and overall survival were retrospectively analyzed using the SPSS 13.0 software pack. Results： Of the 48 FL patients, 38 cases （ 79.2% ） were categorized with low-level expression, 10 cases （ 20.8% ） with high-level expression. No significant relationship between LAM expression and patient clinical characteristics was observed. The treatment response of patients with low-level expression was similar to those with high-level expression （ ORR 91.7% vs. 100.0%, P = 1.000; CR 63.2% vs. 55.6%, P=1.000 ）. Median survival time （MST） has not been reached. The MST of patients with low LAM expression was superior to that in the high expression group （ P = 0.002 ）. Multivariate analysis showed LAM expression was not associated with the overall survival of patients. Conclusion： High-level LAM expression may be associated with poor FL prognosis whereas no statistical significance was observed because of the minority of patients and insufficient follow-up. Further investigation is warranted.