弥漫大B细胞淋巴瘤的B7-H4表达情况及临床特征相关性分析  

Expression of B7-H4 protein and its relationship with clinical characteristics in diffuse large B-cell lymphoma

作　　者：郭淑萍[1] 童茵[1,2] 倪万茂[1,3] 沈丹[1] 童向民[1,3] 

机构地区：[1]浙江大学医学院附属第一医院血液科,杭州310003 [2]上海市第一人民医院血液科,上海200080 [3]浙江省人民医院血液科,杭州310014

出　　处：《中华危重症医学杂志（电子版）》2015年第2期1-5,共5页Chinese Journal of Critical Care Medicine:Electronic Edition

基　　金：浙江省科技厅公益技术研究社会发展项目(2011C23089;2012C13021-3)

摘　　要：目的探讨B7-H4蛋白在弥漫大B细胞淋巴瘤(DLBCL)患者淋巴组织中的表达情况及其与临床特征的相关性。方法选取2007年3月至2011年9月在浙江大学医学院附属第一医院血液内科就诊的164例患者,其中142例为DLBCL患者(DLBCL组),9例患者为正常淋巴结(对照组),13例患者为炎症性淋巴结(炎症组),对所有患者淋巴结组织进行样本采集,采用免疫组化方法测定B7-H4蛋白表达,分析B7-H4在三组患者中的表达情况。将DLBCL组按照B7-H4的表达情况分为高表达组与低表达组,分析其表达高低与DLBCL患者临床特征及预后的关系。结果 DLBCL在三组患者中阳性率表达的比较差异有统计学意义(χ2=36.946,P<0.001)。与对照组相比,DLBCL组B7-H4表达水平较高,DLBCL组与炎症组相比表达水平增高,差异均有统计学意义(P<0.001,P=0.002)。DLBCL组的高表达组与低表达组在年龄(χ2=0.009,P=0.932)、性别(χ2=0.007,P=0.925)、临床分期(χ2=0.534,P=0.465)及结外侵犯(χ2=1.932,P=0.165)方面的比较差异均无统计学意义。对患者中位随访40个月,Kaplan-Meier生存分析显示,无论经联合或未联合利妥昔单抗的CHOP化疗,低表达组与高表达组的生存时间比较,差异均无统计学意义(χ2=0.345,P=0.557;χ2=1.001,P=0.317)。结论 DLBCL患者的肿瘤组织中B7-H4表达明显增高,提示B7-H4的表达与DLBCL的发生可能有一定的相关性。Objective To investigate the expression of B7-H4 protein and its relationship with clinical characteristics in patients with diffuse large B-cell lymphoma （DLBCL）. Methods A total of 164 patients admitted to the Hematology Department of First Affiliated Hospital, Zhejiang University School of Medicine from March 2007 to September 2011 were enrolled in the study, including 142 DLBCL patients （DLBCL group）, 9 patients with normal lymph nodes （normal nodes group） and 13 patients with inflammatory lymph nodes （inflammatory group）. The expression of B7-H4 protein on lymph nodes tissues was examined by immunohistochemiealstaining in all the patients. The expression levels of B7-H4 were compared in the three groups, and then patients in the DLBCL group were divided into the high expression subgroup and low expression subgroup. The relationship between B7-H4 expression and clinical features, prognosis in DLBCL patients were analyzed. Results There were significant differences of positive expression of DLBCL in the three groups （x^2 = 36.946, P 〈 0.001）. Compared with the normal nodes group, B7-H4 was over-expressed in the DLBCL group （P〈 0.001）. The expression of B7-H4 in DLBCL patients were higher than that in the inflammatory group （P = 0.002）. There were no statistical differences in age （x^ = 0.009, P= 0.932）, gender （x^2 = 0.007, P = 0.925）, clinical stages （x^2 = 0.534, P= 0.465） and extranodal infiltrations （x^2 = 1.932, P= 0.165） between the high expression subgroup and the low expression subgroup. After a median of 40-month follow-up, the Kaplan-Meier survival analysis showed the expression levels of B7-H4 had no effect on survival time in patients with DLBCL no matter rituximab joint the CHOP chemotherapy or not （x^2 = 0.345, P= 0.557;x^2 = 1.001, P= 0.317）. Conclusion The B7-H4 over expressed in DLBCL patients, therefore B7-H4 might be related with the incidence of DLBCL.

关 键 词：淋巴瘤 大B-细胞 弥漫性 B7-H4 化疗 预后 

分 类 号：R733.1[医药卫生—肿瘤]