CD30在弥漫大B细胞淋巴瘤中的表达及其临床意义

Expression of CD30 in Diffuse Large B Cell Lymphoma and Its Clinical Significance

目的:评估肿瘤坏死因子受体超家族蛋白CD30在原发弥漫大B细胞淋巴瘤(DLBCL)中的表达及临床意义。方法:回顾分析2008年1月-2012年12月就诊我院血液科的149例DLBCL患者中63例非特殊类型(DLBCL,NOS)患者的CD30表达水平,分析患者的临床特点和预后状况。结果:CD30表达与患者年龄、性别、B症状、Ann Arbor分期、体力状态(ECOG PS评分)、乳酸脱氢酶(LDH)水平、结外累及病灶数、国际预后指数(IPI)、Hans分型及骨髓累及无显著相关。单因素分析显示,CD30表达水平、年龄、ECOG PS评分、B症状、结外累及病灶数、LDH、IPI评分、是否存在骨髓累及,是否使用美罗华是影响整体OS和EFS的临床因素。单因素分析还显示,对于GCB型DLBCL患者,CD30表达水平对OS和EFS均无显著影响,而对于non GCB型DLBCL患者,CD30+不仅是OS的影响因素(P=0.037),还提示倾向于较好的EFS(P=0.067)。多因素分析提示IPI评分和CD30是影响OS的独立预后因素(IPI评分:P=0.000,95%CI 0.042-0.374 CD30:P=0.044,95%CI 1.055-60.613)。对于EFS,IPI评分是其独立预后因素(P=0.000,95%CI 0.040-0.360),而CD30+患者明显倾向于较长的EFS(P=0.050,95%CI 0.996-56.501)。结论:CD30与DLBCL预后存在一定相关性,对判断DLBCL患者预后存在一定临床价值,有望成为评估DLBCL预后的新指标。

Objective: To evaluate the expression and clinical significance of tumor necrosis factor receptor( TNFR)superfamily protein CD30 in diffuse large B cell lymhoma( DLBCL). Methods: The CD30 expression, clinical characteristics and prognosis of 63 patients w ith DLBCL,NOS out of 149 patients w ith DLBCL admitted in our hospital betw een January 2008 and December 2012 w ere analyzed retrospectively. Results: no significant relationship existed betw een CD30 expression and clinical features,such as age,sex,B symptoms,staging,ECOG PS,LDH level,extranodal site involvement,IPI,GCB or non GCB type,bone marrow involvement. By univariate analysis,the clinical factors associated w ith general OS and EFS,included C D30,EC O G PS,B sym ptom s,extranodal site involvem ent,L D H level,IPI,bone m arrow involvem ent and rituxim ab. U nivariate analysis in G C B D L B C L indicated that C D30 had no significant effect on O S and EFS. How ever,univariate analysis in non-G C B D L B C L indicated C D30 w as associated w ith longer O S( P = 0. 037) and show ed a tendency of better EFS( P = 0. 067). In m ultivariate analysis,IPI and C D30 w ere independent prognostic factors for O S( IPI: P = 0. 000,95 % C I 0. 042- 0. 374,C D30 : P = 0. 044,95 %C I 1. 055- 60. 613),and IPI also w as independent prognostic factors for EFS( P = 0. 000,95 % C I 0. 040- 0. 360).C D30+and D L B C L have a tendency of better EFS( P = 0. 050,95 % C I 0. 996- 56. 501). Conclusion: C D30 expression level correlates w ith the prognosis of D L B C L and has a certain clinical value, w hich m ay be a new prognostic index of D L B CL.