弥漫大B细胞淋巴瘤免疫亚型与临床特征及疗效的关系

Study on the clinical feature and therapeutic effect of diffuse large B-cell lymphoma's immunologic subtype

目的探讨弥漫大B细胞淋巴瘤(DLBCL)免疫亚型与一线CHOP化疗方案的疗效关系。方法采用免疫组化链霉素抗生物素蛋白-过氧化物酶连接法(SP)检测60例DLBCL石蜡组织中MUM-1、bcl-6和CD10的表达,确定弥漫大B细胞淋巴瘤免疫亚型。60例患者均采用CHOP或CHOP样方案化疗,观察各组的疗效及不良反应。结果弥漫大B细胞淋巴瘤GCB型和非GCB型各30例,GCB型组患者完全缓解率、稳定率合有效率分别为56.7%、6.7%和93.3%,非GCB型租患者完全缓解率、稳定率及有效率分别为26.7%、13.3%和76.7%,两组患者疗效差异有统计学意义(P<0.05)。GCB型组患者3年生存率明显高于非GCB型组,差异有统计学意义(P<0.05)。两组患者不良反应差异无统计学意义(P>0.05)。结论 DLBCL免疫学亚型与CHOP方案疗效存在一定关系,可以作为预后判断的重要因素。

Objective To explore the clinical feature and therapeutic effect of diffuse large B-cell lymphoma＇s immunologic subtype. Methods The DLBCL＇s immunologic subtype was identified by immuno- histochemistry of MUM-1 ,bcl-6 and CD10. Patients of GCB group and non-GCB group both received CHOP chemotherapy. Therapeutic effect and adverse effect were observed. Results The complete remission rate, stable disease rate and overall response rate of GCB group were 56. 7% ,6. 7% and 93.3%, while the non- GCB group were 26. 7% ,13.3% and 76. 7%, respectively. The therapeutic effect of the two groups was statistically different（ P 〈 0.05）. The three-year survival rate of GCB group was higher than that of non-GCB group, which had significant difference（ P 〈 0. 05 ）. The adverse effect of the two groups was not statistically different（P 〉 0. 05 ）. Conclusion DLBCL＇s immunologic subtype is related to the therapeutic effect of CHOP chemotherapy and is an important prognostic factor.