C1QA水平与R-CHOP方案治疗弥漫大B细胞淋巴瘤患者疗效和预后的关系

Relationship of C1QA level and therapeutic effect and prognosis of DLBCL patients treated with R-CHOP

目的探讨R-CHOP方案(利妥昔单抗+环磷酰胺+阿霉素+长春新碱+泼尼松)或类R-CHOP方案治疗的弥漫大B细胞淋巴瘤(DLBCL)患者治疗前血浆补体水平与临床病理特征和预后的关系。方法收集2010—2016年于中国医学科学院肿瘤医院就诊的105例DLBCL患者的临床病理资料。采用抗体芯片检测R-CHOP或类R-CHOP治疗的105例DLBCL患者治疗前和80例健康对照者血浆中34种补体的水平,分析DLBCL患者治疗前血浆补体水平与临床病理特征和预后的关系。结果国际预后指数(IPI)评分为3~5分患者血浆中补体C1QA的信号值为1261.43±138.96,与IPI评分为0~2分患者(950.79±80.19)比较,差异有统计学意义(P=0.037)。IPI评分为3~5分患者的CR1L信号值为2214.69±98.58,与IPI评分0~2分患者(1984.67±121.79)比较,差异有统计学意义(P=0.017)。非完全缓解(non-CR)组患者的C1QA信号值为1165.43±98.56,与完全缓解(CR)组(914.70±100.77)比较,差异有统计学意义(P=0.045);non-CR组患者的CR1L信号值为2263.13±145.63,与CR组(1821.34±84.68)比较,差异有统计学意义(P=0.008)。Cox回归分析显示,血浆中C1QA信号值升高与DLBCL患者的无进展生存时间(HR=2.063,95%CI为1.220~3.489,P=0.007)和总生存时间(HR=2.23,95%CI为1.036~4.798,P=0.040)有关。采用多因素Cox回归进行IPI评分校正后,血浆C1QA信号值升高仍与无进展生存时间有关(HR=1.765,95%CI为1.034~3.013,P=0.037)。结论采用R-CHOP或类R-CHOP方案治疗的DLBCL患者基线血浆中C1QA和CR1L水平与患者的IPI评分和疗效有关,C1QA血浆基线水平对DLBCL患者的预后具有一定的预测价值。

Objective To investigate the relationship between plasma levels of complements before treatment and the clinicopathological feathers and prognoses of diffuse large B-cell lymphoma(DLBCL)patients treated with Rituximab(R)-CHOP or R-CHOP-like therapy.Methods The clinicopathological data of 105 DLBCL patients treated in cancer Hospital of Chinese Academy of Medical Sciences from 2010 to 2016 were collected.The plasma samples from 105 DLBCL patients treated with R-CHOP or R-CHOP-like therapy and 80 healthy controls were used to detect 34 complement levels before treatment by utilizing antibody microarray.The relationship between plasma levels of complements and the clinicopathological feathers and prognosis of DLBCL patients were analyzed.Results The signal values of C1QA and CR1L in patients with international prognostic index(IPI)scores of 3-5 were 1261.43±138.9 and 2214.69±98.58,respectively,higher than 950.79±80.19 and 984.67±121.79 in patients with IPI scores of 0~2(both P<0.05).The levels of C1QA and CR1L in the non-complete response(CR)group were 1165.43±98.56 and 2263.13±145.63,respectively,higher than 914.70±100.77 and 1821.34±84.68 in the CR group(both P<0.05).Cox regression analysis showed that elevated C1QA signal value was associated with poor progression-free survival(PFS)and poor overall survival(OS)(PFS:HR=2.063,95%CI:1.220-3.489,P=0.007;OS:HR=2.23,95%CI:1.036~4.798,P=0.040).After IPI correction by Cox multivariate model,the elevated C1QA signal value was still correlated with poor PFS(HR=1.765,95%CI 1.034~3.013,P=0.037).Conclusions The baseline plasma levels of C1QA and CR1L are correlated with IPI scores and therapeutic effects of DLBCL patients treated with R-CHOP.The baseline plasma level of C1QA has a certain predictive value for the prognostic evaluation of DLBCL.