摘要
目的探讨初治Myc/Bcl-2蛋白双表达的弥漫大B细胞淋巴瘤患者临床特点及预后。方法回顾性分析2014年1月—2018年8月北京大学首钢医院收治的69例初治弥漫大B细胞淋巴瘤患者病例资料,根据是否存在Myc肿瘤细胞≥40%同时伴Bcl-2肿瘤细胞≥50%,分为双表达组及非双表达组,对二组患者的临床特点进行分析,所有患者应用R-CHOP(利妥昔单抗,环磷酰胺,盐酸表柔比星,长春新碱,醋酸泼尼松)方案,至少治疗4个周期,进行疗效评估和生存分析。结果同非双表达组相比,双表达组活化B细胞来源更多见,且分期更晚、乳酸脱氢酶(LDH)水平更高、国际预后指数(IPI)评分更高、更易出现大肿块,差异有统计学意义(P<0.05),非双表达组2年总生存(OS)率及2年无进展生存(PFS)率均显著优于双表达组,差异有统计学意义(均P<0.05)。COX比例风险回归模型分析显示,Myc/Bcl-2蛋白双表达和IPI评分是弥漫大B细胞淋巴瘤的独立预后因素。结论双表达弥漫大B细胞淋巴瘤患者活化B细胞来源、分期Ⅲ-Ⅳ期、LDH水平升高、IPI评分3~5分、存在大肿块较非双表达患者更常见,一线应用R-CHOP方案仍有效,但总体预后不佳。
Objective To investigate the clinical characteristics and prognosis of patients with diffuse large B-cell lymphoma with double expression of Myc/Bcl-2 protein.Methods A retrospective analysis of the case data of sixty-nine newly treated patients with diffuse large B-cell lymphoma admitted to Peking University Shougang Hospital from January 2014 to August 2018,based on whether there are Myc tumor cells≥40%and Bcl-2 tumor cells≥50%,divided into dual expression group and non-dual expression group.The clinical characteristics of the two groups of patients are analyzed.All patients are treated withR-CHOP(rituximab,cyclophosphamide,epirubicinhydrochloride,vincristine,prednisone)regimen for at least 4 cycles to evaluate the efficacy and analyze the difference in survival between the two groups.Results Compare with the non double expression group,the double expression group has more sources of activated B cells,andwith a later stage,a higher LDH level,a higher IPI score,and more likely to appear a bulky mass,the difference are statistically significant(P<0.05).The non double expression group have both 2-year OS rates and 2-year PFS rates Significantly better than the double expression group,the difference arestatistically significant(P<0.05).The COXproportional hazards model showed that Myc/Bcl-2 protein double expression and IPI score are independent prognostic factors for diffuse large Bcelllymphoma.Conclusion Indouble expression patients,the source of activated B cells、stage III-IV、elevated LDH levels、IPI scores of 3-5 points,and bulky mass are more commonthan those innon double expression patients.Patients with newly diagnosed double expression diffuse large Bcell lymphoma should be treated with R-CHOP which is still effective,but the overall prognosis is poor.
作者
王明迪
崔海佳
吴道香
黄燕华
马晓彩
胡守奎
高乃姝
余延芳
WANG Mingdi;CUI Haijia;WU Daoxiang;HUANG Yanhua;MA Xiaocai;HU Shoukui;GAO Naishu;YU Yanfang(Peking University Shougang Hospital,Beijing 100041,China)
出处
《中国煤炭工业医学杂志》
2021年第5期459-464,共6页
Chinese Journal of Coal Industry Medicine
基金
北京市自然科学基金面上项目(编号:7192240)
作者简介
通讯作者:余延芳
