淋巴结滤泡辅助T细胞淋巴瘤-血管免疫母细胞型临床病理特征和预后因素分析  

Clinicopathological features and prognostic factors of nodal T-follicular helper cell lymphoma,angioimmunoblastic-type

作　　者：贺娟 王星宇 何鸿[2] 王立鑫 谭艳梅 李源鑫 黄颖 余快 赵敏 谢涛 李丹 He Juan;Wang Xingyu;He Hong;Wang Lixin;Tan Yanmei;Li Yuanxin;Huang Ying;Yu Kuai;Zhao Min;Xie Tao;Li Dan(Department of Pathology,Faculty of Basic Medicine,Chongqing Medical University;Department of Gastroenterology,The First Branch,The First Affiliated Hospital of Chongqing Medical University)

机构地区：[1]重庆医科大学基础医学院病理学教研室,重庆400016 [2]重庆医科大学附属第一医院第一分院消化内科,重庆400016

出　　处：《重庆医科大学学报》2024年第7期895-903,共9页Journal of Chongqing Medical University

基　　金：重庆医科大学重点资助项目(编号:ZHYX202104)。

摘　　要：目的:探讨淋巴结滤泡辅助T细胞淋巴瘤-血管免疫母细胞型(nodal T-follicular helper cell lymphoma,angioimmunoblastic-type,nTFHL-AI)临床病理特征和预后因素。方法:回顾性分析63例nTFHL-AI患者临床信息,利用免疫组化(immuno⁃histochemistry,IHC)、原位杂交(in situ hybridization,ISH)和抗原受体基因重排评估nTFHL-AI临床病理特征。使用Cox比例风险回归模型评估预后因素。结果:免疫染色提示CD4阳性肿瘤细胞例数明显超过CD8(66%vs.5%)。Epstein-Barr病毒(Epstein-Barr virus,EBV)编码的小RNA(EBV-encoded small RNA,EBER)阳性患者比EBER阴性患者更易表达CXCL13(P=0.006)。5年总体生存期(overall survival,OS)和无进展生存期(progression-free survival,PFS)分别为31%和16%。CXCL13阳性组OS和PFS显著优于CXCL13阴性组(P=0.003、P=0.040)。相反,BCL6阳性表达与较差的OS和PFS相关(P=0.026、P=0.044),EBER阴性也与较差的OS和PFS相关(P=0.013、P=0.047)。多因素分析表明EBER阴性是OS和PFS独立不良预后因素(P=0.001、P=0.003)。结论:CXCL13阳性预示nTFHL-AI患者预后良好,而BCL6阳性和EBER阴性与患者预后不良相关,并且EBER阴性是患者预后的独立危险因素。Objective:To investigate the clinicopathologic features and prognostic factors of nodal T-follicular helper cell lymphoma,angioimmunoblastic-type(nTFHL-AI).Methods:A retrospective analysis was performed for the clinical information of 63 patients with nTFHL-AI,and immunohistochemistry,in situ hybridization,and antigen receptor gene rearrangement were used to assess the clinicopathological features of nTFHL-AI.The Cox proportional hazards regression model was used to investigate prognostic factors.Re⁃sults:Immunostaining showed that the number of patients with dominant CD4-positive cells was significantly higher than that of pa⁃tients with dominant CD8-positive cells(66%vs.5%).The patients who tested positive for Epstein-Barr virus-encoded small RNA(EBER)showed a higher probability for the expression of CXCL13 compared with their EBER-negative counterparts(P=0.006).The 5-year overall survival(OS)rate and the progression-free survival(PFS)rate were 31%and 16%,respectively.The CXCL13-positive group had significantly better OS and PFS than the CXCL13-negative group(P=0.003 and 0.040).On the contrary,positive BCL6 ex⁃pression was associated with worse OS and PFS(P=0.026 and 0.044),and negative EBER was also associated with worse OS and PFS(P=0.013 and 0.047).The multivariate analysis showed that nega⁃tive EBER was an independent negative prognostic factor for both OS and PFS(P=0.001 and 0.003).Conclusion:Positive expression of CXCL13 indicates a favorable prognosis of nTFHL-AI patients,while positive BCL6 and negative EBER are associated with poor prognosis,and negative EBER is an independent risk factor for the prognosis of patients.

关 键 词：淋巴结滤泡辅助T细胞淋巴瘤-血管免疫母细胞型 滤泡辅助T细胞表型 Epstein-Barr病毒编码的小RNA 预后 

分 类 号：R363[医药卫生—病理学]