血管免疫母细胞性T细胞淋巴瘤中CD200和可诱导共刺激分子的表达及意义  

Expressions of CD200 and inducible costimulator in angioimmunoblastic T-cell lymphoma and their significances

作　　者：李晓杰[1] 李爱平 张伟 刘伶俏 陈亚辉 石旦 陈贤永[5] 何韧 Li Xiaojie;Li Aiping;Zhang Wei;Liu Lingqiao;Chen Yahui;Shi Dan;Chen Xianyong;He Ren(Pathology Diagnosis Center,the First People's Hospital of Chenzhou,Chenzhou 423000,China;Department of Pathology,People's Hospital of Huadu District,Guangzhou 510800,China;Department of Pathology,the Fourth People's Hospital of Chenzhou,Chenzhou 423000,China;Department of Pathology,Hainan Women and Children's Medical Centre,Haikou 570000,China;Department of Pathology,Xiangnan College Affiliated Hospital,Chenzhou 423000,China;Department of Pathology,Chenzhou 3rd People's Hospital,Chenzhou 423000,China)

机构地区：[1]湖南省郴州市第一人民医院病理诊断中心,423000 [2]广州市花都区人民医院病理科,510800 [3]湖南省郴州市第四人民医院病理科,423000 [4]海南省妇女儿童医学中心病理科,海口570000 [5]湘南学院附属医院病理科,湖南郴州423000 [6]湖南省郴州市第三人民医院病理科,423000

出　　处：《白血病．淋巴瘤》2021年第7期400-406,共7页Journal of Leukemia & Lymphoma

基　　金：湖南省郴州市第一人民医院院内基金(N2018-004、N2017-012)。

摘　　要：目的:探讨CD200和可诱导共刺激分子(ICOS)蛋白在血管免疫母细胞性T细胞淋巴瘤(AITL)中的表达情况、与预后的关系及其在AITL鉴别诊断中的意义。方法:选择郴州市第一人民医院、郴州市第四人民医院、湘南学院附属医院及郴州市第三人民医院2012年6月至2019年12月39例AITL患者和郴州市第一人民医院2016年8月至2019年7月诊断为经典霍奇金淋巴瘤(CHL)及非特指型外周T细胞淋巴瘤(PTCL-NOS)患者各10例。免疫组织化学法检测CD200、ICOS、CD10、程序性死亡受体1(PD-1)、bcl-6及CXC趋化因子配体13(CXCL13)蛋白表达情况,分析CD200、ICOS蛋白与AITL患者的临床病理特征及预后的关系,及二者在AITL与PTCL-NOS、CHL鉴别诊断中的意义。结果:39例AITL患者中CD200、ICOS蛋白阳性率分别为71.79%(28/39)、61.54%(24/39);10例CHL患者中CD200弱至中等阳性7例,ICOS蛋白均为阴性;10例PTCL-NOS患者中,CD200阳性4例,ICOS蛋白阳性1例;AITL患者与CHL、PTCL-NOS患者间ICOS蛋白阳性率比较,差异均有统计学意义(均 P<0.05);AITL患者与CHL、PTCL-NOS患者间CD200蛋白阳性率比较,差异均无统计学意义(χ^(2)=0.013, P=0.911;χ^(2)=3.551, P=0.060)。乳酸脱氢酶(LDH)升高及国际预后指数(IPI)评分为3~4分的AITL患者CD200阳性率高于相应的LDH正常和IPI评分0~2分患者(均 P<0.05);LDH升高及PD-1阳性AITL患者ICOS阳性率高于相应的LDH正常和PD-1阴性患者(均 P<0.05)。CD200阳性与阴性AITL患者3年总生存(OS)率(4.2%比66.7%)和3年无进展生存(PFS)率(5.3%比77.1%)比较,差异均具有统计学意义(均 P<0.01);ICOS蛋白阳性与阴性AITL患者3年OS率(15.3%比38.6%)比较,差异具有统计学意义( P=0.011),两组间3年PFS率(18.6%比41.5%)比较,差异无统计学意义( P=0.059)。多因素分析结果显示,CD200( HR=0.076,95% CI 1.555~79.497, P=0.001)、结外是否受累( HR=11.117,95% CI 1.555~79.497, P=0.016)、LDH( HR=2.147,95% CI 0.844~5.459, P=0.109)是AITL患者OS的独立�Objective To investigate the expressions of CD200 and inducible costimulator(ICOS)protein in angioimmunoblastic T-cell lymphoma(AITL)and the relationship with prognosis as well as their significances in the differential diagnosis of AITL.Methods A total of 39 AITL patients in the First People's Hospital of Chenzhou,the Fourth People's Hospital of Chenzhou,Xiangnan College Affiliated Hospital and Chenzhou 3rd People's Hospital from June 2012 to December 2019,and 10 patients with classic Hodgkin lymphoma(CHL)and 10 patients with peripheral T cell lymphoma,not otherwise specified(PTCL-NOS)from August 2016 to July 2019 in the First People's Hospital of Chenzhou were selected.Immunohistochemistry was used to detect the expressions of CD200,ICOS,CD10,programmed death 1(PD-1),bcl-6 and CXC chemokine receptor-13(CXCL13)proteins,and the correlation of CD200 and ICOS with clinicopathological features and prognosis of AITL patients was analyzed,and the diagnostic significance of both in differentiating AITL from PTCL-NOS and CHL was also analyzed.Results The positive rates of CD200 and ICOS in 39 AITL patients were 71.79%(28/39)and 61.54%(24/39),respectively.There were 7 cases of CD200 weak and moderate positive in 10 CHL patients,and ICOS proteins were all negative.Among 10 PTCL-NOS patients,4 patients had CD200 positive and 1 patient had ICOS positive.The differences in positive rates of ICOS protein between AITL patients and CHL,PTCL-NOS patients were statistically significant(all P<0.05);the differences in positive rates of CD200 protein between AITL patients and CHL,PTCL-NOS patients were not statistically significant(χ^(2)=0.013,P=0.911;χ^(2)=3.551,P=0.060).The positive rate of CD200 in AITL patients with elevated lactate dehydrogenase(LDH)and international prognostic index(IPI)score of 3-4 was higher than that in AITL patients with normal LDH and IPI score of 0-2(both P<0.05);The positive rate of ICOS in AITL patients with elevated LDH and PD-1 positive was higher than that in AITL patients with normal LDH and PD-1

关 键 词：淋巴瘤 T细胞 血管免疫母细胞性T细胞淋巴瘤 抗原 CD200 可诱导共刺激分子 预后 诊断 鉴别 

分 类 号：R732.2[医药卫生—肿瘤]