CD20在经典型霍奇金淋巴瘤HRS细胞中的表达及其与预后的关系  

Prognostic Significance of CD20 Expression in Hodgkin and Reed-Sternberg Cells of Classical Hodgkin's Lymphoma

作　　者：付晓红[1,2] 王树森[1,2] 黄岩[1,2] 肖健[1,2] 翟林柱[1,2] 夏忠军[1,2] 黄慧强[1,2] 孙晓非[1,2] 林桐榆[1,2] 

机构地区：[1]华南肿瘤学国家重点实验室,广东广州510060 [2]中山大学肿瘤防治中心内科,广东广州510060

出　　处：《癌症》2008年第11期1197-1203,共7页Chinese Journal of Cancer

摘　　要：背景与目的:B淋巴细胞标记CD20在经典型霍奇金淋巴瘤(classical Hodgkin's lymphoma,CHL)HRS(Hodgkin and Reed-Sternberg)细胞的表达率为5%～58%,CD20表达对预测CHL预后的意义仍有争议。本研究旨在了解CD20在中国CHLHRS细胞中的表达情况及其与预后的关系。方法:收集1995年1月到2004年12月在中山大学肿瘤医院存档的70例初治CHL石蜡标本,HE染色和免疫组化法行CD20、CD15和CD30染色。以高于10%的HRS细胞胞膜表达CD20作为阳性标准。单因素分析采用log-rank检验,采用Cox部分风险模型进行多因素分析。结果:21例(30.0%)CHLHRS细胞CD20阳性,年龄≥45岁的CHL患者CD20的阳性率(53.3%)显著高于年龄<45岁患者(23.6%)(P=0.026)。26例CHL(37.1%)患者CD15阳性,70例CHL均为CD30阳性。全组中位随访时间58.3个月,CD20(+)组和CD20(-)组CHL5年无失败生存率分别为76.2%和77.6%(P=0.484);5年总生存率分别为80.4%和92.5%(P=0.006)。多因素分析显示,年龄和分期为CHL无失败生存和总生存的独立预后因素。结论:CD20在CHLHRS细胞的阳性率为30%,年龄≥45岁CHL患者HRS细胞CD20阳性率显著高于年龄<45岁患者,但未能证实CD20是初治CHL无失败生存和总生存期的独立预后因素。BACKGROUND ＆ OBJECTIVE. Hodgkin and Reed-Sternberg （HRS） cells of classical Hodgkin＇s Lymphoma （CHL） express B-cell marker CD20 with a reported frequency of 5%-58%. The prognostic significance of CD20 expression in HRS cells of CHL is still controversial. This study was to investigate the prognostic significance of CD20 expression in naive CHL patients. METHODS： The expression of CD20, CD15 and CD30 in 70 specimens of CHL were detected by immunohistochemistry; tumor morphology was observed with HE staining. A sample with CD20 expression on more than 10% of HRS cells was considered CD20-positive. The failurefree survival （FFS） and overall survival COS） rates were compared by logrank test. Cox proportional hazard model was used in multivariate analysis. RESULTS. Of the 70 cases of CHL, 21 （30.0%） were CD20-positive, 26 （37.1%） were CD15-positive, and all were CD30-positive. The positive rate of CD20 was significantly higher in the patients aged I〉45 years than in those aged 〈45 years （53.3% vs. 23.6%, P=0.026）. The patients were followed up for a median of 58.3 months. The 5-year FFS rates were 76.2% in CD20- positive patients and 77.6% in CD20-negative patients （P=0.484）. The 5- year OS rates were 80.4% in CD20-positive patients and 92.5% in CD20- negative patients （P=0.006）. Cox multivariate analysis showed that age and stage were independent prognostic factors for FFS and OS. CONCLUSIONS.. The positive rate of CD20 is relatively low in HRS cells of CHL. It is higher in the patients aged ≥45 years than in those aged 〈45 years. However, according to our results, the expression of CD20 is not an independent prognostic factor for FFS and OS of naive CHL patients.

关 键 词：霍奇金淋巴瘤 预后 CD20 免疫表型 

分 类 号：R733.1[医药卫生—肿瘤]