弥漫大B细胞淋巴瘤预后的相关因素探讨  

Multivariate Analysis of the Parameters Related to Recurrence of Diffuse Large B Cell Lymphoma

作　　者：姚丽青[1] 申洪[1] 郑智勇[1] 余英豪[1] 

机构地区：[1]南方医科大学病理学教研室

出　　处：《中国肿瘤临床》2005年第14期781-783,共3页Chinese Journal of Clinical Oncology

基　　金：国家自然科学基金(编号:60372027);福建省自然科学基金资助(编号:A0310010)

摘　　要：目的:探讨弥漫大B细胞淋巴瘤(DLBCL)中微血管密度、Ki-67标记指数、bcl-6阳性率与患者预后的关系。方法:应用免疫组织化学染色法检测血管内皮细胞特异性标记物CD34和Ki-67、bcl-6的表达,通过形态学计量法计数肿瘤内微血管密度。结果:1)肿瘤微血管密度与Ki-67标记指数有关(P<0.01),与bcl-6表达阳性率无关;2)Kaplan-Meier分析显示微血管计数≤21.5(×200倍)的弥漫大B细胞淋巴瘤预后较好,而微血管计数>21.5(×200倍)预后较差;3)肿瘤细胞Ki-67的标记指数值在28.2%～85.6%之间,中位数59.4%,标记指数>59.4%较≤59.4%者预后差;4)bcl-6表达阳性率在12.4%～90.8%之间,中位数42.0%,阳性率>42.0%较≤42.0%者预后好。结论:弥漫大B细胞淋巴瘤微血管密度计量、Ki-67标记指数和bcl-6阳性率是评价患者预后的重要指标。Objective： To investigate the relationship between microvessel density （MVD）, ki-67 and bcl-6 as well as the prognosis in diffuse large B-cell lymphoma. Methods： Specific endothelial cell markers CD34 and the ki-67 and bcl-6 gene expression were detected with immunohistochemistry and microvessel density was counted by morphometry. Results： 1） There was a significant correlationship between the MVD and the ki-67 labelling index but bcl-6; 2） The microvessel count was associated with overall survival by Kaplan-Meier analysis. An average blood vessel count of less than 21.5 suggested a better survival, but a higher vessel count of more than 21.5 showed a trend to worsen the overall survival; 3） A ki-67 labelling index of less than 59.4 suggested a better survival, but a higher ki-67 labelling index of more than 59.4 showed a trend to worsen the overall survival; 4） A bcl-6 positive of more than 42.0 suggested a better survival, but a lower bcl-6 positive of less than 42.0 showed a trend to worsen the overall survival. Conclusion： The results suggest a significant correlationship among MVD, ki-67 labelling index, bcl-6 positive and prognosis. Moreover MVD, ki-67 and bcl-6 may be the useful prognostic indicators in diffuse large B-cell lvmphoma.

关 键 词：弥漫大B细胞淋巴瘤 微血管密度Ki-67 bcl-6预后 

分 类 号：R733.1[医药卫生—肿瘤]