原发性中枢神经系统淋巴瘤79例临床病理特征及预后分析

Clinicopathological characteristics and prognosis of primary central nervous system lymphoma:report of 79 cases

目的探讨原发性中枢神经系统淋巴瘤(PCNSL)患者临床病理学特征及预后相关指标。方法选择手术切除或活检的PCNSL临床病例资料79份,采用HE染色及En Vision二步法观察PCNSL组织病理学特征和免疫表型特征,单因素分析患者发病年龄、部位深浅、病灶数目、国际预后指数(IPI)评分及分子亚型同预后的关系,并用COX回归模型多因素分析影响患者预后的因素。结果 PCNSL以弥漫大B细胞淋巴瘤(DLBCL)最为常见,且以非生发中心(non-GCB)细胞来源多见。单因素结果显示:发病年龄、IPI指数、Bcl-6蛋白表达与预后相关(P<0.05),COX回归模型显示IPI评分是独立的预后因素(P<0.05)。结论 PCNSL是一种高度侵袭性非霍奇金淋巴瘤(NHL),预后差,生存率低,IPI评分是独立预后因素。DLBCL生发中心(GCB)与non-GCB亚型预后未显示有显著差异。

Objective To study the clinicopathological characteristics and prognostic factors of primary central nervous system lymphoma （PCNSL）. Methods A total of 79 cases of PCNSL were collected by surgical removal or biopsy, and then pathological characteristics and immunophenotype were observed by using HE staining and EnVision immunohistochemistry. Univariate analysis was used to study the relationships between prognosis and the factors including age, site, number of lesions, IPI score and immune subtype. Then we used the Cox regression model to analyze multivariate influence factors. Results The most common type of PCNSL was diffuse large B cell lymphoma （DLBCL） and the immunophenotype was mainly non-GCB type. Univariate analysis showed that age, IPI score and BCL-6 protein expression were releted to the prognosis （ P 〈 0.05 ）. Multivariate analysis showed that IPI score was an independent factor （ P 〈 0. 05 ）. Conclusion PCNSL is a highly invasive cancer, with poor prognosis, and short-term mortality is high. IPI score is an independent factor. There is no significant difference in the prognosis between GCB and non-GCB subtypes of DILBCI.