CD43在弥漫大B细胞淋巴瘤中的表达及临床意义

Expression and clinical value of CD43 in diffuse large B cell lymphoma

目的:探讨CD43在弥漫大B细胞淋巴瘤(DLBCL)中的表达情况及其临床意义。方法:采用流式细胞术检测76例初发DLBCL患者淋巴结和结外组织中CD43抗原的表达情况,分析CD43表达与患者重要临床特征以及预后的关系。结果:CD43表达与患者年龄、临床分期、ECOG评分、乳酸脱氢酶值、结外受累数目、B症状、巨大包块、国际预后指数(IPI)评分以及疗效等临床特征均无关(均P>0.05),仅与细胞起源有关(P=0.002)。生存分析发现CD43阳性表达患者3年总生存期显著短于CD43阴性患者(48%∶78%,P=0.012),亚组分析结果显示non-GCB亚型患者中CD43阳性表达者3年总生存时间亦显著短于CD43阴性者(32%∶64%,P=0.008),这种差异在低中危组患者中也存在(54%∶81%,P=0.03),而中高危组患者中未见明显差异(36%∶42%,P=0.215)。结论:CD43表达是DLBCL免疫学亚型相关的预后标志物,而且CD43联合IPI评分更能准确地评估低中危患者的预后。

Objective：To investigate the expression levels and clinical significance of CD43 in diffuse large B cell lymphoma（DLBCL）.Method：Flow cytometry was used to detect the expression of CD43 antigen in the lymph nodes and extranodal tissues in 76 newly diagnosed DLBCL patients.The correlation between the expression of CD43 and clinical features and prognosis was analyzed.Result：The expression of CD43 showed no significant correlation with age,clinical stage,ECOG performance status,LDH value,numbers of extranodal involvement,B symptoms,huge mass,international prognostic index（IPI）score and treatment effect（P〉0.05）,but significantly correlated with the cell of origin（P=0.002）.The survival analysis showed patients with CD43-positive DLBCL had an inferior 3-year OS compared to those who were CD43-negative（48% vs.78%,P=0.012）.CD43 expression was an inferior survival within the non-GCB subgroup（3-year OS 32% vs.64%,P=0.008）and within the low IPI（0 to 2 points）subgroup（3-year OS 54% vs.81%,P=0.03）,whereas no difference was observed in the high IPI（3 to 5 points）subgroup（3-year OS 36% vs.42%,P=0.215）.Conclusion：The expression of CD43 can be used as apoor prognostic marker in DLBCL with non-GCB subtype.CD43 combined with IPI can accurately assess the prognosis of DLBCL patients with low-middle risk.