CD5^(+)弥漫大B细胞淋巴瘤的荟萃分析

Meta-analysis of CD5^(+) diffuse large B-cell lymphoma

目的:运用荟萃分析评价影响CD5^(+)弥漫大B细胞淋巴瘤(diffuse large B cell lymphoma,DLBCL)的相关因素。方法:系统检索PubMed、Cochrane Library、EMBASE、Web of Science、中国知网和万方数据库。检索数据库建库至2020年4月4日发表的CD5^(+)DLBCL预后情况的研究文献,对纳入研究进行资料提取及质量评估,采用Revman5.3软件及STATA软件进行合并分析。结果:最终纳入11篇文献,总样本量为3094例。荟萃分析危险因素的合并OR值(95%CI)分别为年龄≥60岁(1.71,95%CI:1.30~2.25),男性(OR=0.85,95%CI:0.55~1.31),Ⅲ~Ⅳ期(OR=1.92,95%CI:1.30~2.83),IPI评分3~5(OR=2.00,95%CI:1.61~2.49),ECOG≥1分(OR=2.39,95%CI:1.80~3.17),LDH升高(OR=1.59,95%CI:0.95~2.66),B症状存在(OR=1.62,95%CI:1.27~2.06),结外侵犯>2处(OR=1.63,95%CI:1.05~2.54),骨髓侵犯(3.62,95%CI:2.28~5.75),中枢神经系统复发(OR=2.07,95%CI:0.89~4.81),BCL-2^(+)(OR=3.11,95%CI:2.07~4.67),BCL-6^(+)(OR=2.07,95%CI:0.89~4.81),non-GCB亚型(OR=2.14,95%CI:1.46~3.13),OS(lnHR=0.93,95%CI:0.34~1.51),PFS(HR=2.37,95%CI:1.09~3.65)。结论:CD5^(+)DLBCL患者以中老年女性多见,临床分期晚预后差,在缺乏随机对照实验的情况下,为更好地评估患者预后,CD5^(+)DLBCL患者应常规行BCL-2免疫组织化学检测,并在有条件的情况下行FISH检测BCL-2基因易位情况。

Objective:To evaluate related factors affecting the mortality of CD5^(+)diffuse large B cell lymphoma(DLBCL)by Meta-analysis.Methods:PubMed,the Cochrane Library,EMBASE,Web of science,CNKI and Wanfang database were searched for studies on prognosis of CD5^(+)DLBCL from the establishment of the databases to April 4,2020.Data extraction and quality evaluation were carried out in the included research,and Revman 5.3 software and STATA software were used for combined analysis.Results:A total of 11 articles and 3094 cases were included.The combined OR values(95%CI)of each risk factor were:age≥60 years(OR=1.71,95%CI:1.30–2.25),male(OR=0.85,95%CI:0.55-1.31),Clinical stageⅢ–Ⅳ(OR=1.92,95%CI:1.30–2.83),IPI score 3–5(OR=2.00,95%CI:1.61–2.49),ECOG score≥1(OR=2.39,95%CI:1.80–3.17),elevated LDH level(OR=1.59,95%CI:0.95–2.66),B symptoms(OR=1.62,95%CI:1.27–2.06),extranodal involvement>2 sites(OR=1.63,95%CI:1.05–2.54),bone marrow involvement(OR=3.62,95%CI:2.28–5.75),central nervous system relapses(OR=2.07,95%CI:0.89–4.81),BCL-2^(+)(OR=3.11,95%CI:2.07–4.67),BCL-6^(+)(OR=2.07,95%CI:0.89–4.81),the non-GCB subtype(OR=2.14,95%CI:1.46–3.13),OS(lnHR=0.93,95%CI:0.34–1.51),PFS(HR=2.37,95%CI:1.09–3.65).Conclusion:This study shows that CD5^(+)DLBCL patients are more common in middle-aged and elderly women,and the clinical stage is late and the prognosis is poor.In the absence of randomized controlled trials,in order to better evaluate the prognosis of patients,CD5^(+)DLBCL patients should routinely carry out BCL-2 immunohistochemical detection,and if possible,FISH should be used to detect the translocation of BCL-2 gene.