高级别B细胞淋巴瘤26例临床分析  

Clinical analysis of 26 patients with high-grade B-cell lymphoma

作　　者：杨万秋 张旭东[2] 陈清江[2] YANG Wanqiu;ZHANG Xudong;CHEN Qingjiang(Department of Oncology,the First Affiliated Hospital,Xinxiang Medical University,Xinxiang,Henan 453100;Department of Oncology,the First Affiliated Hospital,Zhengzhou University, Zhengzhou 450052)

机构地区：[1]新乡医学院第一附属医院肿瘤科,河南新乡453100 [2]郑州大学第一附属医院肿瘤科,郑州450052

出　　处：《郑州大学学报（医学版）》2020年第4期564-567,共4页Journal of Zhengzhou University(Medical Sciences)

基　　金：国家自然科学青年基金项目(81700187)。

摘　　要：目的:探讨高级别B细胞淋巴瘤(HGBL)的临床特征、病理特征和治疗效果。方法:收集郑州大学第一附属医院2014年6月至2019年4月HGBL患者26例的临床资料,并进行回顾性分析。结果:26例HGBL患者中HGBL,非特指型(HGBL,NOS)患者12例,发病年龄55(24~72)岁,免疫组化MYC^+和BCL^2+双表达5例,GCB型10例,FISH检测结果显示MYC^+/BCL^2-/BCL6^-4例、MYC^-/BCL^2+3例、MYC^-/BCL6^+3例;HGBL伴有双打击/三打击患者(HGBL-DT)14例,发病年龄53(23~74)岁,MYC^+和BCL^2+双表达10例,GCB型13例,FISH检测结果显示MYC^+/BCL^2+/BCL6^-7例、MYC^+/BCL^2-/BCL6^+4例、MYC^+/BCL^2+/BCL6^+3例。12例HGBL,NOS患者PFS为14(2~58)个月,OS为15(3~58)个月,2例患者行CODOX-M/IVAC方案治疗均评价为CR。14例HGBL-DT患者PFS为7(2~26)个月,OS为11(4~48)个月。结论:HGBL患者生存期短,易侵犯结外器官,好发于GCB型,目前尚无标准的治疗方案。HGBL,NOS患者可考虑行CODOX-M/IVAC方案治疗。Aim:To investigate clinical characteristics,pathological features and therapeutic effects of high-grade B-cell lymphoma(HGBL).Methods:The clinical data of 26 patients who were diagnosed HGBL in the First Affiliated Hospital of Zhengzhou University from June 2014 to April 2019 were collected and analyzed retrospectively.Results:Among the 26 patients with HGBL,there were 12 cases with not otherwise specified(HGBL,NOS)type and 14 cases with double-hit/triple-hit(HGBL-DT)type.Cases of HGBL,NOS were characterized by age of onset 55(24~72)years,among which,5 cases with double expression of MYC/BCL2 by immunohistochemical(IHC)examination,10 cases with germinal center B-cell(GCB)type and the results of fluorescence in situ hybridization(FISH)test showed 4 cases with MYC^+/BCL^2-/BCL6^-,3 cases with MYC^-/BCL^2+,3 cases with MYC^-/BCL6^+.Cases of HGBL-DT were characterized by age of onset 53(23~74)years,10 cases with double expression of MYC/BCL2 by IHC examination,13 cases with GCB type and the results of FISH test showed 7 cases with MYC^+/BCL^2+/BCL6^-,4 cases of MYC^+/BCL^2-/BCL6^+,3 cases of MYC^+/BCL^2+BCL6^+.The progression free survival(PFS)and overall survival(OS)of patients with HGBL,NOS were 14(2~58)months and 15(3~58)months,respectively and 2 patients treated with CODOX-M/IVAC regimen were both achieved complete remission.The PFS and OS of 14 patients with HGBL-DT were 7(2~26)months and 11(4~48)months,respectively.Conclusions:The patients with HGBL are easy to be invaded in external organs,and most patients are GCB type and have a short survival period.There is no standard treatment regimen for patients with HGBL.CODOX-M/IVAC regimen may be a choice for patients with HGBL,NOS.

关 键 词：高级别B细胞淋巴瘤 介于弥漫大B细胞淋巴瘤与伯基特淋巴瘤未分类B细胞淋巴瘤 双打击淋巴瘤 三打击淋巴瘤 

分 类 号：R733.4[医药卫生—肿瘤]