323例原发弥漫大B细胞淋巴瘤中CD30表达及其临床病理意义  

Expression of CD30 and its clinicopathologic characteristics in primary diffuse large B cell lymphoma:a retrospective study of 323 cases

作　　者：刘艳梅 姬文莉 岳娜 郭云泉[1] 李新霞 LIU Yan-mei;JI Wen-li;YUE Na;GUO Yun-quan;LI Xin-xia(Department of Pathology,the 3rd Affiliated Teaching Hospital of Xinjiang Medical University/Affiliated Cancer Hospital,Urumqi 830000,China)

机构地区：[1]新疆医科大学第三临床医学院/附属肿瘤医院病理科,乌鲁木齐830000

出　　处：《临床与实验病理学杂志》2022年第7期836-841,共6页Chinese Journal of Clinical and Experimental Pathology

基　　金：新疆医科大学科研创新基金(XYDCX201665)。

摘　　要：目的探讨原发弥漫大B细胞淋巴瘤(diffuse large B cell lymphoma,DLBCL)中CD30蛋白表达模式及CD30阳性DLBCL的临床病理学特征。方法回顾性分析323例原发DLBCL的临床病理学特征,并行CD30等免疫组化染色及EBER原位杂交检测。结果323例DLBCL中原发淋巴结190例,汉族与少数民族病例比为2.3∶1,中位年龄61岁(24~95岁),年龄>60岁者170例(52.6%)。以肿瘤细胞CD30阳性率>0为阳性阈值,79例(24.5%)呈CD30阳性,阳性定位于细胞膜和(或)高尔基区,CD30阳性率≥80%者17例(21.5%),阳性率<20%者15例(19.0%);CD30阳性DLBCL更易累及淋巴结(P=0.012)、non-GCB型比例更高(P=0.013)、EBER阳性率更高(P=0.001)、更易发生骨髓累及(P=0.049)、间变型形态更多见(P<0.001);CD30阳性DLBCL组和CD30阴性DLBCL组总生存期(overall survival,OS)和无进展生存期(progression free survival,PFS)差异无统计学意义;CD30阳性组汉族患者临床分期Ⅲ+Ⅳ期比例高于少数民族(P=0.021),CD30阳性率≥80%患者出现B症状的几率较CD30阳性率20%~79%患者低(P=0.01);Cox多因素分析显示:EBER状态和治疗方式是影响CD30阳性DLBCL患者OS的独立预后因素。CD30阴性组汉族患者CD5的阳性率高于少数民族(P=0.022)。结论CD30阳性DLBCL具有独特的临床病理学特征,但CD30作为DLBCL预后标志物的证据尚不充分,需进一步扩大样本量进行分析,以评估抗CD30靶向治疗DLBCL的可行性。Purpose To investigate the expression and clinicopathological features of CD30 positive primary diffuse large B cell lymphoma(DLBCL).Methods The clinicopathological features of 323 de novo DLBCL cases were retrospectively analyzed,with immunohistochemical staining such as CD30 and EBER in situ hybridization.Results Among the 323 DLBCL,190 cases involved lymph nodes and the ratio of Han to minority nationality was 2.3∶1,with a median age of 61 years(ranging from 24 to 95 years),and 170 cases(52.6%)were over 60 years.Using a cut-off value>0,CD30 expression was found in 79(24.5%)cases,and≥80%in 17(21.5%),<20%in 15(19.0%).Compared with CD30-negative DLBCL,CD30-positive DLBCL was more frequently involved in lymph nodes(P=0.012),more non-GCB subtype(P=0.013),higher EBER positive(P=0.001),higher bone marrow involvement(P=0.049),and more anaplastic type(P<0.001).No significant differences were found in overall survival(OS)and progression free survival(PFS)between the two groups.In CD30-positive DLBCL,the proportion of Ann Arbor stageⅢ+Ⅳin Han was higher than minority patients(P=0.021).The incidence of B symptoms in patients with CD30 expression≥80%was lower than that the patients with CD30 expression(20%-79%).Cox regression showed that EBER status and treatment were independent prognostic factors for OS in CD30-positive DLBCL.In CD30-negative DLBCL,the expression rate of CD5 in Han nationality was higher than that in minority(P=0.022).Conclusion CD30-positive DLBCL has unique clinicopathological features,but the evidence of CD30 as a prognostic marker of DLBCL is not sufficient yet.Further studies with larger samples should be performed to evaluate the feasibility of anti-CD30 targeted treatment for DLBCL.

关 键 词：淋巴瘤 弥漫大B细胞淋巴瘤 CD30 免疫组织化学 原位杂交 

分 类 号：R733.4[医药卫生—肿瘤]