Clinicopathologic features of surgically resected primary gastric lymphoma

AIM:To analyze the clinicopathologic characteristics of surgically resected gastric lymphoma patients. METHODS:We retrospectively analyzed 57 surgically resected gastric lymphoma patients,dividing them into 2 subgroups:Low grade MALToma (the LG group),High grade MALToma and Diffuse large B cell lymphoma (the HG group). RESULTS:The numbers of patients were:20 in the LG group, 37 in the HG group.The diagnostic rate of gastroscopy was 34.8% at primary diagnosis and 50% including differential diagnoses.The positive rates of Hpyloriwere similar between the 2 groups (68% vs77%).Multiple lesions were found in 19.3%.The proportion of mucosal and submucosal lesions was 80.0%(16/20) in the LG group,and 24.3%(9/37) in the HG group (P<0.001).Lymph node invasion rates were 10.5%(2/19) in the LG group and 44.1%(15/34) in the HG group (P=0.031).The numbers of recurred patients were none in the LG group,and 8 in the HG group.By univariant analysis,group (P=0.024) and TNM stage (stage Ⅰ,Ⅱ vs stages Ⅲ,Ⅳ,P=0.002) were found to be the significant risk factors.There was a tendency of higher recurrence rate in the subtotal gastrectomy group than in the total gastrectomy group (P=0.50). CONCLUSION:The HG groups had a more advanced stage and a higher recurrence rate than the LG group.Although there was no difference between subtotal and total gastrectomies,more careful assessments of multiplicities and radical resections with lymph node dissections seem to be needed because of multiplicity and LN invasion even in LG group.

利妥昔单抗联合化疗治疗弥漫型大B细胞淋巴瘤的临床观察

目的:探讨利妥昔单抗联合化疗治疗弥漫型大B细胞淋巴瘤患者的临床疗效和安全性。方法:回顾性分析100例病理确诊为弥漫型大B细胞淋巴瘤患者的临床资料。所有患者均接受2～8次的利妥昔单抗治疗,利妥昔单抗的平均治疗次数为5.8次。同时,所有患者均接受了化疗。评价疗效和不良反应。结果:100例患者中达完全缓解者46例(46%),达部分缓解者37例(37%),总有效率(完全缓解+部分缓解)为83%(83/100)。红细胞沉降率、国际预后指数评分、是否为初治患者、B症状以及利妥昔单抗治疗周期数对疗效有显著影响(P<0.05),而性别、年龄、原发部位和功能状态评分对疗效无影响(P>0.05)。1、2、3和5年生存率分别为87.5%、72.8%、60.8%和60.8%。COX回归模型多因素分析发现,国际预后指数评分、利妥昔单抗治疗周期数和治疗后的疗效对生存的影响有统计学意义(P<0.05)。100例患者中共有11例因静脉输注利妥昔单抗而发生输液不良反应。结论:利妥昔单抗联合化疗治疗弥漫型大B细胞淋巴瘤的临床缓解率较高,患者耐受良好且生存时间较长。

二硫化二砷诱导LY8细胞株凋亡的机制探讨

目的探讨二硫化二砷诱导弥漫大B细胞淋巴瘤细胞株LY8凋亡的机制。方法将不同浓度的二硫化二砷与弥漫大B细胞淋巴瘤细胞株LY8共培养。采用CCK-8方法测定细胞活性;AnnexinⅤ-PI方法测定细胞凋亡率,采用Western blot技术在蛋白水平测定凋亡相关因子BCL-2、Bax和caspase-3的表达。结果随着二硫化二砷浓度的增高,细胞活性越低,细胞凋亡率越高;随着二硫化二砷作用时间的延长,细胞活性越低,细胞凋亡率也越高。其差异均有统计学意义。Western blot结果显示:与对照组比较,二硫化二砷下调caspase-3蛋白的表达,Bax/BCL-2的比例升高并伴随着Bax断裂。结论二硫化二砷以时间和剂量依赖的方式抑制LY8细胞生长和诱导凋亡,诱导凋亡的机制可能与线粒体通路相关,并伴随着Bax断裂。