环氧合酶-2影响弥漫大B细胞淋巴瘤患者预后相关因素初探  

The prognostic impact of cyclooxygenase-2 in patients with diffuse large B-cell lymphoma

作　　者：化范例[1,2] 高松[2] 邬扬炯[2] 李莹[2] 王小云[1] 程韵枫[1] 

机构地区：[1]复旦大学附属中山医院血液科,上海200032 [2]复旦大学附属金山医院血液科,上海201508

出　　处：《复旦学报（医学版）》2012年第3期243-246,共4页Fudan University Journal of Medical Sciences

基　　金：上海市金山区科委基金项目(2010-3-13);上海市科学技术委员会浦江人才计划(09PJ1402500)~~

摘　　要：目的探讨环氧合酶-2(cycloxygenase-2,COX-2)对弥漫大B细胞淋巴瘤(diffuse large B-celllymphoma,DLBCL)患者预后的影响及其相关因素。方法根据2008年WHO淋巴造血组织肿瘤分类重新确认47例非特指型DLBCL患者的病理诊断,并区分生发中心型和非生发中心型。采用免疫组化EnVision二步法检测石蜡包埋肿瘤病理组织中COX-2的表达并分析其与患者预后的关系,同时检测标本BCL-2、Ki67以及P-糖蛋白(P-gp)的表达。结果 47例DLBCL患者中生发中心型仅占14.9%(7/47);11例表达COX-2,阳性率为23.4%,均来自于非生发中心型DLBCL(P=0.133)。COX-2阳性和阴性患者的中位生存时间分别为20个月和46个月;COX-2阳性患者的1年和5年生存率分别为54.55%和21.82%,而COX-2阴性患者则分别为91.43%和39.26%。两组的生存曲线差异具有统计学意义(P=0.028)。COX-2阳性标本中P-gp与BCL-2阳性表达率较COX-2阴性者高(P=0.020;P=0.004),但Ki67的表达在两组之间无明显差异(P=0.846)。结论本研究提示阳性表达COX-2的非特指型DLBCL患者多为非生发中心来源,预后较差,高表达P-gp与Bcl-2可能是其不良预后的重要影响因素。Objective To investigate the impact of cyclooxygenase-2 on prognosis in patients with diffuse large B-cell lymphoma（DLBCL） and its related factors.Methods The pathological diagnoses of forty-seven cases of DLBCL（not otherwise specified,NOS）were reconfirmed and then were classified into germinal center B cell-like（GCB） type or non-GCB type based on WHO classification of tumors of haematopoietic and lymphoid tissues（4th edition）.Immunohistochemical EnVision method was performed to detect the expression of COX-2 in the paraffin-embedded tissues of DLBCL.The correlation between COX-2 and the prognoses of these patients was analyzed.Also,the expression of BCL-2,P-glycoprotein（P-gp）and Ki67 were detected.Results In all 47 cases,only 7 cases were GCB type（14.9%）.COX-2 was expressed in 11 samples（23.4%）,which were all non-GCB type（P=0.133）.The median survival of COX-2 positive patients was 20 months,while that of COX-2 negative was 46 months.The one year and 5-year survival of COX-2 positive group was 54.55% and 21.82%,while in COX-2 negative group it was 91.43% and 39.26% respectively.COX-2 expression correlates with poor prognosis（P=0.028）.The positive rates of P-gp and BCL-2 were higher in COX-2 positive samples compared with that of COX-2 negative ones（P=0.020;P=0.004）,while the difference of Ki67 expression between the two groups was not significant（P=0.846）.Conclusions The study suggested that a majority of patients with DLBCL（NOS） expressing COX-2 were non-GCB type,and COX-2 expression correlated with poor prognosis,whose contributive factors might be over-expression of P-gp and BCL-2.

关 键 词：弥漫大B细胞淋巴瘤 环氧合酶-2 预后 P-糖蛋白 BCL-2 

分 类 号：R733.4[医药卫生—肿瘤]