LMR和CD163^(+)TAM对弥漫大B细胞淋巴瘤患者预后的评估价值

Prognostic Value of LMR and CD163^(+)TAM for Patients with Diffuse Large B Cell Lymphoma

目的:探究淋巴细胞和单核细胞比值(LMR)和CD163^(+)肿瘤相关巨噬细胞(TAM)对弥漫大B细胞淋巴瘤(DLBCL)患者预后的评估价值。方法:收集63例初诊DLBCL患者外周血和淋巴结组织。检测患者血常规,得出淋巴细胞和单核细胞数量,计算出LMR。采用免疫组化方法检测淋巴结组织中CD163^(+)TAM数量。采用ROC曲线确定LMR和CD163^(+)TAM的截断值,分析LMR和CD163^(+)TAM与DLBCL患者预后指标的相关性。结果:63例初诊DLBCL患者的LMR的水平为3.69±1.71,CD163^(+)TAM的中位值为26/HPF。CD163^(+)TAM与LMR呈负相关(r=-0.58),与单核细胞计数呈正相关(r=0.46)。采用ROC曲线确定LMR和CD163^(+)TAM临界值分别为2.95和29/HPF,并以此将患者分为低LMR组和高LMR组以及低CD163^(+)TAM组和高CD163^(+)TAM组。低LMR组临床分期Ⅲ-Ⅳ期、IPI评分3-5分以及存在骨髓浸润的患者比例均明显高于高LMR组(P<0.05)。高CD163^(+)TAM组临床分期Ⅲ-Ⅳ期、IPI评分3-5分、LDH水平升高以及存在骨髓浸润的患者比例均明显高于低CD163^(+)TAM组(P<0.05)。LMR与OS呈正相关(r=0.43),CD163^(+)TAM比例与OS呈负相关(r=-0.65)。低LMR组和高CD163^(+)TAM组的DLBCL患者具有更短的OS(P<0.05)。结论:低LMR和高CD163^(+)TAM可以作为DLBCL患者预后不良的生物学标志。

Objective:To investigate the prognostic value of lymphocyte-to-monocyte ratio(LMR)and CD163^(+)tumorassociated macrophages(TAM)in patients with diffuse large B cell lymphoma(DLBCL).Methods:Peripheral blood and lymph node tissues were collected from 63 newly diagnosed DLBCL patients.LMR was calculated by the number of lymphocytes and monocytes in peripheral blood from the result of blood routine examination.The level of CD163^(+)TAM in lymph nodes was detected by immunohistochemistry.The cut-off values of LMR and CD163^(+)TAM were determined by ROC curves,and the prognostic value of LMR and CD163^(+)TAM in DLBCL patients was analyzed.Results:The LMR level of 63 newly diagnosed DLBCL patients was 3.69±1.71,and the median value of CD163^(+)TAM was 26/HPF.The number of CD163^(+)TAM was negatively correlated with LMR(r=-0.58)and positively correlated with monocyte count(r=0.46).The cut-off values of LMR and CD163^(+)TAM determined by ROC curve were 2.95 and 29/HPF,respectively,and based on this,the patients were divided into low LMR group and high LMR group,as well as low CD163^(+)TAM group and high CD163^(+)TAM group.The proportion of patients with clinical stageⅢ-Ⅳ,IPI score 3-5 and bone marrow infiltration in the low LMR group were higher than those in the high LMR group(P<0.05).The proportion of patients with clinical stageⅢ-Ⅳ,IPI score 3-5,elevated LDH level and bone marrow infiltration in the high CD163^(+)TAM group were higher than those in the low CD163^(+)TAM group(P<0.05).There was a positive correlation between LMR and OS(r=0.43)and a negative correlation between CD163^(+)TAM and OS(r=-0.65).DLBCL patients with low LMR and high CD163^(+)TAM had shorter OS(P<0.05).Conclusion:Low LMR and high CD163^(+)TAM can be used as biological markers for poor prognosis of DLBCL patients.