目的探讨EB病毒(Epstein-Barr virus,EBV)在原发性扁桃体弥漫大B细胞淋巴瘤(primary tonsillar diffuse large B cell lymphoma,PTDLBCL)内的感染情况及其临床病理学意义。方法采用EBV编码微小RNA(EBV encoded miRNA,EBERs)原位杂交(in ...目的探讨EB病毒(Epstein-Barr virus,EBV)在原发性扁桃体弥漫大B细胞淋巴瘤(primary tonsillar diffuse large B cell lymphoma,PTDLBCL)内的感染情况及其临床病理学意义。方法采用EBV编码微小RNA(EBV encoded miRNA,EBERs)原位杂交(in situ hybridization,ISH)和EBV潜伏膜蛋白1(latent membrane protein 1,LMP1),PCR检测EBV在PTDLBCL(n=81)和原发性非扁桃体弥漫大B细胞淋巴瘤(primary nontonsillar diffuse large B cell lymphoma,PNTDLBCL)(n=42)、鼻腔NK/T细胞淋巴瘤(n=10)及慢性扁桃体炎(n=20)中的感染情况,并分析差异。结果 ISH结果显示,PTDLBCL中EBV的阳性率高于PNTDLBCL(t=5.603,P=0.018)。检测PTDLBCL中EBV,PCR阳性率显著高于ISH(t=11.139,P=0.001)。EBV阳性PTDLBCL者预后优于阴性者(t=5.683,P=0.017);与患者年龄、部位及性别的差异无统计学意义。结论EBV在PTDLBCL中高表达,其存在与患者预后正相关。检测PTDLBCL的EBV,LMP1PCR的敏感度高于EBERs ISH,而EBERs ISH的特异度高于LMP1PCR。展开更多
弥漫大B细胞淋巴瘤（diffuse large B cell lymphoma，DLBCL）是成人淋巴瘤中较常见的一种类型，其在临床表现、组织形态和预后等方面具有较大的异质性。DLBCL患者的诊断、预后评估等相关实验室检查需抗凝外周血样，我们在临床工作中遇...弥漫大B细胞淋巴瘤（diffuse large B cell lymphoma，DLBCL）是成人淋巴瘤中较常见的一种类型，其在临床表现、组织形态和预后等方面具有较大的异质性。DLBCL患者的诊断、预后评估等相关实验室检查需抗凝外周血样，我们在临床工作中遇到DLBCL患者外周抗凝血样出现异常凝集，现报告其中1例典型病例并进行相关文献复习，以提高对该疾病的认识。展开更多
<strong>Objective</strong>: Exploring the expression characteristics of CRP/ALB (CAR) in DLBCL patients and its value in prognostic judgment. <strong>Methods:</strong> We collected the basic in...<strong>Objective</strong>: Exploring the expression characteristics of CRP/ALB (CAR) in DLBCL patients and its value in prognostic judgment. <strong>Methods:</strong> We collected the basic information, clinical characteristics, laboratory examinations and follow-up prognosis of 142 newly diagnosed DLBCL patients with relatively complete data in our hospital and performed statistical analysis. We used X-tile analysis software to obtain the best cut-off value of CAR (0.33), compared the clinical characteristics and survival of patients in the high CAR group and the low CAR group, and compared the survival status with the IPI scoring system. <strong>Results:</strong> 1) There were significant differences in staging, grouping, IPI scores, extranodal involvement, LDH levels, <em>β</em>2-microglobulin, CA125, and Hb levels between the high CAR group and the low CAR group (all <em>P</em> < 0.05). 2) According to the survival curve, the OS of the high CAR group was significantly shorter than that of the low CAR group (<em>P</em> < 0.01), and the one-year, three-year and five-year survival conditions of high CAR group were all shorter than those of low CAR group. 3) COX analysis showed that high CAR is an independent poor prognostic factor for DLBCL patients. 4) A comparative analysis of OS, three-year and five-year survival showed that the combination of CAR and IPI was significantly better than the IPI system, and there was no significant difference in the evaluation value of the prognosis between CAR alone and IPI alone. <strong>Conclusion:</strong> High CAR value, like the IPI scoring system, is an independent poor prognostic factor of DLBCL, can be used as a reliable indicator of prognosis. And CAR can also be combined with IPI to evaluate the prognosis of DLBCL, of which the effect is better than that of IPI alone.展开更多
目的·探究肾脏累及的弥漫性大B细胞淋巴瘤(diffuse large B-cell lymphoma,DLBCL)患者的临床病理特征,包括临床基本信息、病理特征、基因突变谱与预后相关因素等。方法·回顾性分析2005年7月—2021年11月上海交通大学医学院附...目的·探究肾脏累及的弥漫性大B细胞淋巴瘤(diffuse large B-cell lymphoma,DLBCL)患者的临床病理特征,包括临床基本信息、病理特征、基因突变谱与预后相关因素等。方法·回顾性分析2005年7月—2021年11月上海交通大学医学院附属瑞金医院收治的149例肾脏累及的DLBCL患者的临床资料,包括治疗方案、疗效评价及分期等,并采用靶向测序(54个淋巴瘤相关基因)评估患者的基因突变情况。基于患者资料进行生存和预后因素分析。结果·在149例DLBCL肾脏累及的患者中,有87例患者(58.4%)年龄>60岁,121例患者(81.2%)AnnArbor分期为Ⅲ~Ⅳ期,27例患者(18.1%)美国东部肿瘤协作组评分≥2分,121例患者(81.2%)血清乳酸脱氢酶(lactate dehydrogenase,LDH)高于正常上限,111例患者(74.5%)至少存在2个以上淋巴结外器官受累,131例患者(87.9%)国际预后指数≥2分。患者的5年总生存率和5年无进展生存率分别为52.2%和50.4%。在病理特征中,145例患者(97.3%)诊断为非特指型DLBCL。按Hans分型,39例患者(26.2%)属生发中心亚型。在可评估疗效的144例患者中,87例(60.4%)患者取得完全缓解。此外,单因素分析显示:血清LDH升高是肾脏累及的DLBCL患者总体生存时间(P=0.048)和无进展生存时间(P=0.033)的不良预后因素;75例肾脏累及的DLBCL患者的靶向测序显示PIM1(n=23,31%)、MYD88(n=22,29%)、CD79B(n=21,28%)和KMT2D(n=18,24%)存在高频突变,其中CD79B突变与较差的总体生存时间相关(P=0.034)。结论·肾脏累及的DLBCL患者临床特征中血清LDH升高与不良预后有关,基因突变谱中CD79B突变与不良预后有关。展开更多
目的:在蛋白水平上研究国人弥漫性大B细胞淋巴瘤(diffuse large B-cell lymphoma,DLBCL)分子分型的蛋白表型特点,为DLBCL的病理诊断、预后和治疗提供依据。方法:取DLBCL标本52例行HE染色和免疫组化染色。在形态学分型的基础上,利用CD10...目的:在蛋白水平上研究国人弥漫性大B细胞淋巴瘤(diffuse large B-cell lymphoma,DLBCL)分子分型的蛋白表型特点,为DLBCL的病理诊断、预后和治疗提供依据。方法:取DLBCL标本52例行HE染色和免疫组化染色。在形态学分型的基础上,利用CD10、MUM1和bcl-6免疫标记对DLBCL进行分子分型,分为生发中心样B细胞样组(germi-nal center B-cell-like,GCB)和非生发中心样B细胞样组(non-germinal center B-cell-like,non-GCB),分析其在DLBCL中的构成比,及CD10、MUM1和bcl-6的表达情况。结果:本组DLBCL中,non-GCB的构成比超过GCB(69.2%/30.8%);统计学分析表明,GCB组间CD10、bcl-6、CD10/bcl-6的表达率的差异有显著性意义,其中CD10的表达率最高,bcl-6其次,CD10/bcl-6最低;non-GCB组间MUM1、MUM1/bcl-6的表达率的差异有显著性意义。结论:我国的DLBCL多起源于后生发中心B细胞,以non-GCB为主,预后较差。DLBCL在CD10、MUM1和bcl-6表达的差异对判定GCB组和non-GCB组有意义。展开更多
文摘目的探讨EB病毒(Epstein-Barr virus,EBV)在原发性扁桃体弥漫大B细胞淋巴瘤(primary tonsillar diffuse large B cell lymphoma,PTDLBCL)内的感染情况及其临床病理学意义。方法采用EBV编码微小RNA(EBV encoded miRNA,EBERs)原位杂交(in situ hybridization,ISH)和EBV潜伏膜蛋白1(latent membrane protein 1,LMP1),PCR检测EBV在PTDLBCL(n=81)和原发性非扁桃体弥漫大B细胞淋巴瘤(primary nontonsillar diffuse large B cell lymphoma,PNTDLBCL)(n=42)、鼻腔NK/T细胞淋巴瘤(n=10)及慢性扁桃体炎(n=20)中的感染情况,并分析差异。结果 ISH结果显示,PTDLBCL中EBV的阳性率高于PNTDLBCL(t=5.603,P=0.018)。检测PTDLBCL中EBV,PCR阳性率显著高于ISH(t=11.139,P=0.001)。EBV阳性PTDLBCL者预后优于阴性者(t=5.683,P=0.017);与患者年龄、部位及性别的差异无统计学意义。结论EBV在PTDLBCL中高表达,其存在与患者预后正相关。检测PTDLBCL的EBV,LMP1PCR的敏感度高于EBERs ISH,而EBERs ISH的特异度高于LMP1PCR。
文摘弥漫大B细胞淋巴瘤（diffuse large B cell lymphoma，DLBCL）是成人淋巴瘤中较常见的一种类型，其在临床表现、组织形态和预后等方面具有较大的异质性。DLBCL患者的诊断、预后评估等相关实验室检查需抗凝外周血样，我们在临床工作中遇到DLBCL患者外周抗凝血样出现异常凝集，现报告其中1例典型病例并进行相关文献复习，以提高对该疾病的认识。
文摘<strong>Objective</strong>: Exploring the expression characteristics of CRP/ALB (CAR) in DLBCL patients and its value in prognostic judgment. <strong>Methods:</strong> We collected the basic information, clinical characteristics, laboratory examinations and follow-up prognosis of 142 newly diagnosed DLBCL patients with relatively complete data in our hospital and performed statistical analysis. We used X-tile analysis software to obtain the best cut-off value of CAR (0.33), compared the clinical characteristics and survival of patients in the high CAR group and the low CAR group, and compared the survival status with the IPI scoring system. <strong>Results:</strong> 1) There were significant differences in staging, grouping, IPI scores, extranodal involvement, LDH levels, <em>β</em>2-microglobulin, CA125, and Hb levels between the high CAR group and the low CAR group (all <em>P</em> < 0.05). 2) According to the survival curve, the OS of the high CAR group was significantly shorter than that of the low CAR group (<em>P</em> < 0.01), and the one-year, three-year and five-year survival conditions of high CAR group were all shorter than those of low CAR group. 3) COX analysis showed that high CAR is an independent poor prognostic factor for DLBCL patients. 4) A comparative analysis of OS, three-year and five-year survival showed that the combination of CAR and IPI was significantly better than the IPI system, and there was no significant difference in the evaluation value of the prognosis between CAR alone and IPI alone. <strong>Conclusion:</strong> High CAR value, like the IPI scoring system, is an independent poor prognostic factor of DLBCL, can be used as a reliable indicator of prognosis. And CAR can also be combined with IPI to evaluate the prognosis of DLBCL, of which the effect is better than that of IPI alone.
文摘目的·探究肾脏累及的弥漫性大B细胞淋巴瘤(diffuse large B-cell lymphoma,DLBCL)患者的临床病理特征,包括临床基本信息、病理特征、基因突变谱与预后相关因素等。方法·回顾性分析2005年7月—2021年11月上海交通大学医学院附属瑞金医院收治的149例肾脏累及的DLBCL患者的临床资料,包括治疗方案、疗效评价及分期等,并采用靶向测序(54个淋巴瘤相关基因)评估患者的基因突变情况。基于患者资料进行生存和预后因素分析。结果·在149例DLBCL肾脏累及的患者中,有87例患者(58.4%)年龄>60岁,121例患者(81.2%)AnnArbor分期为Ⅲ~Ⅳ期,27例患者(18.1%)美国东部肿瘤协作组评分≥2分,121例患者(81.2%)血清乳酸脱氢酶(lactate dehydrogenase,LDH)高于正常上限,111例患者(74.5%)至少存在2个以上淋巴结外器官受累,131例患者(87.9%)国际预后指数≥2分。患者的5年总生存率和5年无进展生存率分别为52.2%和50.4%。在病理特征中,145例患者(97.3%)诊断为非特指型DLBCL。按Hans分型,39例患者(26.2%)属生发中心亚型。在可评估疗效的144例患者中,87例(60.4%)患者取得完全缓解。此外,单因素分析显示:血清LDH升高是肾脏累及的DLBCL患者总体生存时间(P=0.048)和无进展生存时间(P=0.033)的不良预后因素;75例肾脏累及的DLBCL患者的靶向测序显示PIM1(n=23,31%)、MYD88(n=22,29%)、CD79B(n=21,28%)和KMT2D(n=18,24%)存在高频突变,其中CD79B突变与较差的总体生存时间相关(P=0.034)。结论·肾脏累及的DLBCL患者临床特征中血清LDH升高与不良预后有关,基因突变谱中CD79B突变与不良预后有关。
文摘目的:在蛋白水平上研究国人弥漫性大B细胞淋巴瘤(diffuse large B-cell lymphoma,DLBCL)分子分型的蛋白表型特点,为DLBCL的病理诊断、预后和治疗提供依据。方法:取DLBCL标本52例行HE染色和免疫组化染色。在形态学分型的基础上,利用CD10、MUM1和bcl-6免疫标记对DLBCL进行分子分型,分为生发中心样B细胞样组(germi-nal center B-cell-like,GCB)和非生发中心样B细胞样组(non-germinal center B-cell-like,non-GCB),分析其在DLBCL中的构成比,及CD10、MUM1和bcl-6的表达情况。结果:本组DLBCL中,non-GCB的构成比超过GCB(69.2%/30.8%);统计学分析表明,GCB组间CD10、bcl-6、CD10/bcl-6的表达率的差异有显著性意义,其中CD10的表达率最高,bcl-6其次,CD10/bcl-6最低;non-GCB组间MUM1、MUM1/bcl-6的表达率的差异有显著性意义。结论:我国的DLBCL多起源于后生发中心B细胞,以non-GCB为主,预后较差。DLBCL在CD10、MUM1和bcl-6表达的差异对判定GCB组和non-GCB组有意义。
