共查询到17条相似文献,搜索用时 156 毫秒
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目的 探讨Choi和Hans分型在弥漫大B细胞淋巴瘤(DLBCL)预后评价中的意义。方法 收集山西省肿瘤医院病理科有详细随访资料的DLBCL 99例,用免疫组织化学EnVision法检测bcl-2、bcl-6、CD10、FOXP1、GCET1、MUM-1的表达情况。根据Choi和Hans两种分类法分别将所有病例分型。其中35例应用荧光原位杂交技术检测bcl-6基因重排情况。结果 按Hans分类法生发中心B细胞(GCB)型21例,非GCB(nonGCB)型78例;按Choi分类法GCB型23例,nonGCB型76例。GCB型生存率明显优于nonGCB型,差异有统计学意义(P=0.000)。FOXP1蛋白阳性表达与预后呈负相关(P=0.011),GCET1阳性表达则与预后呈正相关(P=0.027)。在35例DLBCL患者中,bcl-6基因重排阳性高发于nonGCB型患者,bcl-6基因重排与bcl-6蛋白的表达没有明显相关性。结论 Choi和Hans两种分类法免疫分型GCB型预后都优于nonGCB型。bcl-6、FOXP1、GCET1的表达与预后有相关性。Choi及Hans分类法对DLBCL的免疫分型、临床预后估计均有应用价值。 相似文献
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目的 探讨bcl-6 、p53、c-myc基因异常的检测在弥漫大B细胞淋巴瘤(DLBCL)中的临床意义.方法 间期荧光原位杂交(I-FISH)方法检测59例DLBCL患者活体石蜡组织bcl-6、p53蛋白、c-myc基因异常的情况,同时以CHOP及R-CHOP方案化疗,评价疗效.观察bcl-6、p53蛋白、c-myc基因与化疗疗效及生存期的关系.结果 59例DLBCL中,p53丢失18例(30.5%),bcl-6重排11例(18.6%),c-myc重排5例(8.5%).p53丢失阳性组化疗有效率(33.3%)明显低于阴性组(76.5%)(x2=9.560,P=0.002). bcl-6基因重排阳性组的预后差于基因重排阴性组,但差异无统计学意义[总生存(OS),P=0.107;无进展生存时间(PFS),P=0.094]; p53基因丢失阳性组预后明显差于阴性组(OS,P=0.031;IPFS,P=0.028);c-myc重排阳性组的预后差于基因重排阴性组,但差异无统计学意义(OS,P=0.163;PFS,P=0.167).其中CHOP化疗组患者,p53基因丢失、c-myc重排阳性组的预后明显差于阴性组,差异有统计学意义(P值均< 0.05);R-CHOP化疗组,bcl-6基因重排阳性组具有较差的预后意义(OS,P=0.003;PFS,P=0.007).结论 bcl-6 、p53、c-myc基因异常与 DLBCL预后密切相关,可作为预测DLBCL的预后因素并指导治疗. 相似文献
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目的探讨采用R-CHOP方案治疗的弥漫大B细胞淋巴瘤(DLBCL)的免疫表型及临床参数与其预后的关系。方法采用免疫组化SP法,检测57例DLBCL中CD10、bcl-6、MUMl和CD5的表达,根据Hans分型将其分为GCB型和non-GCB型。结果 57例DLBCL中表达CD10、bcl-6、MUM1和CD5分别有9例(15.8%)、36例(63.2%)、34例(59.6%)、4例(7.0%);GCB型17例(29.8%)、non-GCB型40例(70.2%)。57例DLBCL中死亡19例,GCB型预后与non-GCB型相比差异无统计学意义(P=0.132);CD5阳性患者死亡率高,但与CD5阴性者相比差异无统计学意义(P=0.594)。Ⅲ~Ⅳ期和年龄>60岁DLBCL患者死亡率高(P=0.001、P=0.017)。结论应用R-CHOP方案治疗的DLBCL其预后与患者年龄和肿瘤临床分期有关,与Hans分型无关。 相似文献
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目的 探讨原发性睾丸弥漫大B细胞性淋巴瘤(DLBCL)的临床病理和免疫表型特征。方法分析10例原发性睾丸DLBCL的临床病理特点;免疫组织化学检测CD10、Bcl-6、MUM1、Bcl-2和Ki-67的表达,并进一步区分其生发中心B细胞(GCB)或非GCB细胞免疫表型。 结果 10例患者平均年龄65岁(51~79岁),Ⅰ~Ⅱ期8例(87.5%)。失访3例,6例患者在发病后5~42月内复发或死亡。CD10、Bcl-6、MUM1、Bcl-2的表达率依次为0,50%,70%,100%。9例显示非GCB细胞免疫表型,1例显示GCB免疫表型。Ki-67平均指数70%。结论 原发性睾丸弥漫大B细胞性淋巴瘤显示非GCB细胞免疫表型特征及Bcl-2和Ki-67高表达可能与其不良预后有关。 相似文献
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【摘要】 目的 探讨瘦素受体(OBR)和磷酸化信号转导与转录激活因子(p-STAT3)在弥漫大B细胞淋巴瘤(DLBCL)中的表达及其与DLBCL免疫表型和临床特征的关系。方法 应用免疫组织化学方法检测80例DLBCL和10例反应性增生淋巴结(RLH)组织中OBR和p-STAT3的表达,并应用免疫组织化学方法检测DLBCL的CD20、CD10、bcl-6、Mum-1免疫标志,根据Hans分型方法将DLBCL分为生发中心B细胞样(GCB)型和非生发中心B细胞样(non-GCB)型。结果 OBR和p-STAT3在DLBCL中的高表达率分别为45.0 %(36/80)和28.8 %(23/80),在RLH中均低表达,差异均有统计学意义(均P<0.05)。p-STAT3在non-GCB型中高表达率为36.8 %(21/57),明显高于GCB型的8.7 %(2/23)(P<0.05),OBR与DLBCL的免疫表型无关(P>0.05)。OBR及p-STAT3在DLBCL临床Ⅲ、Ⅳ期中的高表达率分别为61.9 %(13/21)和38.1 %(8/21),高于Ⅰ、Ⅱ期[46.2 %(18/39)和25.6 %(10/39)],但差异无统计学意义(P>0.05)。OBR和p-STAT3的表达与患者年龄、性别、结外浸润、乳酸脱氢酶水平、B症状及国际预后指数(IPI)评分无关(P>0.05)。OBR和p-STAT3在DLBCL中的表达呈正相关(r=0.232,P=0.039)。结论 OBR可激活JAK-STAT信号途径、促进STAT3磷酸化过程,其可能参与DLBCL的发病和non-GCB型DLBCL的进展。 相似文献
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He XH Li B Yang S Lu N Zhang X Zou SM Li YX Song YW Zheng S Dong M Zhou SY Yang JL Liu P Zhang CG Qin Y Feng FY Shi YK 《癌症》2012,31(6):306-314
To further explore the role of rituximab when added to the CHOP-like regimen in the treatment of immunohistochemically defined non-germinal center B-cell subtype (non-GCB) diffuse large B-celllymphoma (DLBCL), 159 newly diagnosed DLBCL patients were studied retrospectively based on the immunohistochemical evaluation of CD10, Bcl-6, MUM-1, and Bcl-2. Altogether, 110 patients underwent the CHOP-like regimen, and rituximab was added for the other 49 patients. Cox regression analysis showed that compared with the CHOP-like regimen, the rituximab-based regimen (R-CHOP regimen)significantly decreased the risk of disease relapse and progression in CD10-negative patients (P=0.001),Bcl-6-negative patients (P=0.01), and MUM-1-positive patients (P=0.003). The risk of disease relapse in patients with non-GCB subtype (P=0.002) also decreased. In contrast, patients with the opposite immunohistochemical marker expression profile and GCB subtype did not benefit from treatment with the R-CHOP regimen. In addition, non-GCB subtype patients had a significantly higher expression rate of Bcl-2 than GCB subtype patients (P=0.042). Although univariate analysis found that both Bcl-2-positive and-negative patients had significantly higher event-free survival rates with the R-CHOP regimen, only Bcl-2 positivity (P=0.004) maintained significance in the Cox regression analysis. We conclude that the addition of rituximab can significantly improve the prognosis of patients with non-GCB subtype DLBCL, which is closely related to the expression of CD10, Bcl-6, MUM-1, and Bcl-2. 相似文献
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R-CHOP和CHOP方案治疗两种亚型弥漫大B细胞淋巴瘤患者的近期疗效 总被引:1,自引:0,他引:1
背景与目的:根据肿瘤细胞起源不同,可将弥漫大B细胞淋巴瘤(diffuselarge Bcelllymphoma,DLBCL)分为生发中心来源(germinalcenter Bcell like,GCB)及非生发中心来源(non-GCB)两种亚型。在以CHOP方案为标准的化疗基础上,前者预后优于后者。本研究通过比较R-CHOP(Rituximab联合CHOP)和CHOP方案治疗不同亚型DLBCL患者的近期疗效,寻找初诊DLBCL患者最佳一线治疗方案。方法:将2006年11月至2008年2月中山大学肿瘤防治中心内科收治的83例初治DLBCL患者分为GCB和non-GCB两组。按照修订版淋巴瘤疗效评价标准,比较接受R-CHOP或CHOP方案治疗患者的近期疗效;观察Bcl-2在两种亚型中的表达情况,并分析其与近期疗效的关系。结果:83例DLBCL患者中GCB组35例(42.2%),non-GCB组48例(57.8%)。GCB组一线化疗近期总缓解率74.3%,non-GCB组60.4%,两组相比差异有显著性(P=0.006)。Bcl-2在GCB和non-GCB两亚组的表达差异没有显著性:Bcl-2阳性患者采用R.CHOP方案治疗的近期缓解率(75.6%)明显高于用CHOP方案治疗者(47.8%),两组相比差异有显著性(P=0.031):采用不同方案化疗的Bcl-2阴性患者的近期缓解率则差异无显著性(P〉0.05)。结论:GCB组患者接受标准R—CHOP或CHOP方案治疗近期缓解率高于non-GCB组,提示预后良好。加用Rituximab可提高Bcl-2阳性患者的近期缓解率。 相似文献
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Ching-Hung Lin Kuan-Ting Kuo Shih-Sung Chuang Sung-Hsin Kuo Julia Hueimei Chang Kung-Chao Chang Hui-Chen Hsu Hwei-Fang Tien Ann-Lii Cheng 《Clinical cancer research》2006,12(4):1152-1156
PURPOSE: Whether diffuse large B-cell lymphoma (DLBCL) of primary central nervous system origin (PCNSL) is biologically different from DLBCL of peripheral nodal origin (NL) remains unclear. The purpose of this study was to compare the expression frequencies and prognostic significance of a panel of cell differentiation markers between these two disease entities. EXPERIMENTAL DESIGN: This study included HIV-unrelated patients with PCNSL (n = 51) and NL (n = 72) treated at four hospitals in Taiwan for whom archival tumor tissue was available. Immunohistochemistry for CD10, BCL-6, MUM-1, vs38c, CD138, and BCL-2 was done. CD10, BCL-6, and MUM-1 expression results were used to classify all cases into the germinal center B-cell (GCB) or the non-GCB subgroup. The prognostic significances of clinical and immunophenotypic markers were evaluated. RESULTS: Nuclear MUM-1 expression was significantly higher in PCNSL than in NL (P < 0.001; 84% versus 53%). PCNSL tumors were more frequently classified into the non-GCB subgroup than NL tumors (P = 0.020; 78% versus 62%). For patients with PCNSL, univariate analysis showed that patients with BCL-6 expression had a trend towards longer survival (P = 0.073; median survival, 25.3 versus 7.3 months), and multivariate analysis showed BCL-6 was an independent prognostic factor (P = 0.026). For patients with NL, both of univariate (P = 0.003) and multivariate analyses (P = 0.002) showed that GCB was significantly associated with favorable survival. CONCLUSION: The higher frequency of non-GCB subclassification, which was mainly contributed by nuclear MUM-1 expression in PCNSL implies that it has a more differentiated cellular origin than NL. BCL-6 expression in patients with PCNSL and GCB subgroup in patients with NL were favorable prognostic factors. 相似文献
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Ritsuko Seki Koichi Ohshima Tomoaki Fujisaki Naokuni Uike Fumio Kawano Hisashi Gondo Shigeyoshi Makino Tetsuya Eto Yukiyoshi Moriuchi Fumihiro Taguchi Tomohiko Kamimura Hiroyuki Tsuda Ryosuke Ogawa Kazuya Shimoda Kiyoshi Yamashita Keiko Suzuki Hitoshi Suzushima Kunihiro Tsukazaki Masakazu Higuchi Atae Utsunomiya Masahiro Iwahashi Yutaka Imamura Kazuo Tamura Junji Suzumiya Minoru Yoshida Yasunobu Abe Tadashi Matsumoto Takashi Okamura 《Cancer science》2009,100(10):1842-1847
We evaluated the usefulness of prognostic markers in patients with diffuse large B-cell lymphoma (DLBCL) treated with cyclophosphamide, vincristine, doxorubicin, and prednisolone (CHOP) ± rituximab (R-CHOP) in Japan. We studied 730 patients with DLBCL; 451 received CHOP and 279 R-CHOP. We analyzed biopsy samples immunohistochemically for markers of germinal center B cells (CD10, Bcl-6), postgerminal center B cells (Multiple myeloma-1), and apoptosis (Bcl-2). The median follow-up period for surviving patients was 56.4 months for the CHOP group and 25.2 months for the R-CHOP group. DLBCL were categorized as germinal center B (GCB) subtype (352/730; 48.2%) or non-GCB subtype (378/730; 51.8%). In the CHOP group, the high expression of CD10 ( P = 0.022) or Bcl-6 ( P = 0.021), or GCB subtype ( P = 0.05) was associated with better overall survival, whereas the high expression of Bcl-2 ( P = 0.001) or MUM1 ( P = 0.011), or non-GCB subtype ( P = 0.05) was associated with worse overall survival. In the R-CHOP group, however, these biomarkers except Bcl-6 were not significant prognostic factors. The patients with non-GCB subtype showed improved survival in the R-CHOP group ( P = 0.756). The International Prognostic Index was a useful clinical marker of survival in the CHOP group ( P < 0.001) and also in the R-CHOP group ( P < 0.001). Results of improved survival with rituximab addition indicate that the relevance of previously recognized prognostic factors should be re-evaluated. ( Cancer Sci 2009; 100: 1842–1847) 相似文献
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目的:探讨乳腺弥漫大B细胞淋巴瘤(DLBCL)患者的临床特征及预后。方法:回顾性分析2014年5月起至2018年12月我院收治的18例乳腺DLBCL患者的临床特点及预后。结果:在18例患者中,17例为女性,中位年龄为57岁,病变主要累及右侧乳腺(11/18,61.1%)。将其分为原发性乳腺DLBCL(PB-DLBCL)和继发性乳腺DLBCL(SB-DLBCL)两大类。11例(57.6%)PB-DLBCL与7例(42.4%)SB-DLBCL相比,其具有Ann Arbor分期多为Ⅰ-Ⅱ期(P<0.01)、B症状少(P=0.013)、相对更高的白细胞计数(P=0.041)、骨髓未累及(P=0.043)、完全缓解(CR)率高(P=0.049)等特点。生存分析发现PB-DLBCL患者5年总生存期(OS)显著长于SB-DLBCL患者(P=0.013)。本研究以非生发中心B细胞型(non-GCB)居多,生发中心型(GCB)与non-GCB型之间OS无显著差异(P=0.885)。所有获得CR患者的生存期均显著延长(P=0.008)。结论:乳腺DLBCL多见于中年女性,以右侧乳腺肿块为主要临床表现,分子分型多为non-GCB型。与SB-DLBCL患者相比,PB-DLBCL患者具有Ann Arbor分期早、B症状少、相对更高的白细胞计数、骨髓未累及、CR率高等特点,并且生存期显著延长。无论是PB-DLBCL和SB-DLBCL,还是GCB型和non-GCB型,获得CR提示预后良好。 相似文献
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目的 探讨miR-320d表达与弥漫大B细胞淋巴瘤(DLBCL)预后的关系.方法 应用EnVision法对山西省肿瘤医院有随访资料的原发于淋巴结的DLBCL 62例石蜡标本进行CD20、CD3、CD10、bcl-6、Mum-1免疫标记检测,根据Hans分类方法将DLBCL分为生发中心B细胞(GCB)型和非生发中心B细胞(non-GCB)型.采用安捷伦16.0高密度芯片对24例DLBCL石蜡标本进行miRNA表达谱筛选,用实时荧光定量PCR方法对62例DLBCL石蜡标本进行miR-320d表达验证.将1 1例淋巴结反应性增生标本作为对照.结果 62例DLBCL中,GCB型22例(35.5%),non-GCB型40例(64.5%),GCB型miR-320d表达水平是non-GCB型的3.43倍(P=0.034).miR-320d在对照组的表达量是DLBCL的5.65倍(P< 0.001).单因素分析示DLBCL中miR-320d低表达组总生存期低于高表达组,差异有统计学意义(P=0.021).多因素Cox回归模型分析示62例DLBCL中,miR-320d低表达(RR=2.434,95%CI1.148~5.159,P=0.020)为独立于国际预后指数(IPI)的预后不良因素.结论 miR-320d表达下调预示DLBCL预后不良. 相似文献
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Low incidence of BCL-6 gene alterations for diffuse large B-cell lymphomas in Taiwan Chinese 总被引:3,自引:0,他引:3
Chen PM Yang MH Yu IT Lin JT Lin YC Fan FS Wang WS Yen CC Chiou TJ Liu JH 《Cancer》2002,94(10):2635-2644
BACKGROUND: In Western populations, rearrangement of the BCL-6 gene can be identified in 20-40% of patients with diffuse large B-cell lymphoma (DLBCL). Analysis of the BCL-6 gene has revealed the presence of point mutations or small deletions in 70% of DLBCL tumors; however, few studies have investigated BCL-6 gene alteration in patients with non-Hodgkins lymphoma (NHL) of Chinese descent. METHODS: Samples from 135 Taiwanese patients with NHL were examined (28 samples of T-cell NHL and 107 samples of B-cell NHL; 59 samples from patients with DLBCL) for gene rearrangement and mutation of the BCL-6 proto-oncogene using Southern blot analysis and single-strand conformation polymorphism (SSCP) followed by sequence analysis. RESULTS: BCL-6 rearrangement and point mutations were found in 14.8% of patients (n = 20) and in 7.4% of patients (n = 10), respectively. All BCL-6 gene alterations occurred in patients with B-cell NHL, and none occurred in patients with T-cell NHL. Among the 59 patients with DLBCL, BCL-6 gene rearrangements were identified in 10 patients (16.9%), and mutations were identified in 8 patients (13.6%), with the BCL-6 mutation occurring independent of the BCL-6 rearrangement. The incidence of BCL-6 gene rearrangement and mutations in patients with extranodal DLBCL was 9.5% (2 of 21 patients) and 23.8% (5 of 21 patients), respectively. Univariate analysis and multivariate logistic regression found no association between BCL-6 gene alternations and clinical characteristics, including extranodal tumors in patients with DLBCL, and no association between the BCL-6 alterations and prognosis was found. CONCLUSIONS: The incidence of BCL-6 alterations was lower in Taiwanese patients with DLBCL compared with Western populations, and BCL-6 gene alterations showed no prognostic significance in patients with DLBCL. 相似文献