88例恶性淋巴瘤预后相关资料分析  

Lymphoma prognostic correlated factors analysis of 88 cases

作　　者：景红梅[1] 克晓燕[1] 高子芬[2] 王良绪[1] 

机构地区：[1]北京大学第三医院血液科,北京100083 [2]北京大学第三医院病理科,北京100083

出　　处：《北京大学学报（医学版）》2003年第2期128-131,共4页Journal of Peking University:Health Sciences

摘　　要：目的 :了解恶性淋巴瘤 (ML)发病、病理及免疫分型特点 ,探讨基因分型在诊断中的作用。方法 :通过标准链菌素生物素 过氧化物酶标记物法 (SABC法 )对病理标本进行免疫分型 ,PCR检测病理及骨髓标本IgH(FR2A ,3A)和TCR(β,γ)基因重排 ,同时对临床及病理资料进行多因素分析。 结果 :(1)ML中非霍奇金淋巴瘤(NHL)较霍奇金淋巴瘤 (HL)发病率高 ,发病率随年龄增长而递增 ,60岁以上发病者占 3 8.6% ;其平均生存时间明显低于 60岁以下者。 (2 )B NHL发病率为 68.6% ,T NHL为 2 8.6% ;B NHL的 3年生存率高于T NHL。 (3 )低度恶性NHL占 4 2 % ,中、高度恶性占 5 8% ;低度恶性组平均生存时间较中、高度恶性组长 ,但统计学上差异无显著性。生存期分析显示Ⅰ～Ⅱ期NHL预后明显优于Ⅲ～Ⅳ期。 (4)PCR检测病理及骨髓标本的IgH和TCR重排 ,B NHLFR2A的阳性率分别为 66 7%及 5 6 2 % ;FR3A阳性率分别为 90 4 %及 81 2 % ;T NHL中TCRβ、γ阳性率分别为 91.7%及 75 0 % ;病理标本的阳性率略高于骨髓 ,T、B分型与免疫分型相符。结论 :年龄 ,T、B分型和临床分期是影响NHL预后的重要因素 ;分子生物学检测作为辅助手段可以肯定免疫分型结果并补充其不足 。Objective: To analyze the characters of incidence, pathological and immunological phenotype of malignant lymphoma(ML), and to study the significance of IgH and TCR T cell receptor gene rearrangement for NHL typing. Methods: Immunological phenotyping was conducted by SABC,and IgH (FR2A, FR3A)& TCR (β,γ) gene rearrangement detected by PCR of some pathological wax and bone marrow samples. Results: (1) In ML, the percentage of non Hodgkin lymphoma (NHL) was 88.6% and Hodgkin lymphoma (HL) was 11.4%. The incidence increased with the patient's age. The percentage of patients over 60 years was 38.6%, and the median survival time of those older than 60 years was significantly shorter than that of the younger. (2) The percentage of B NHL was 68.6%, and that of T NHL was 28.6%;3 years' survival time rate of B NHL was higher than that of T NHL. (3) The percentage of low grade NHL was 42%, and that of middle and high grade NHL was 58%; and the overall survival time was not significantly different between the two groups. But the overall survival time was longer in patients in stages Ⅰ—Ⅱ than in stages Ⅲ—Ⅳ. (4)The results of detection on wax and bone marrow samples showed that B NHL FR2A were 66.7% and 56.2% positive,FR3A 90.4% and 81.2% positive;in T NHL patients, TCR β and TCR γ gene rearrangements were 91.7% and 75.0% positive;T and B classification were the same as the immunological phenotype. Conclusion: Age, T and B classifications and staging are the important factors, which affect the prognosis of NHL. Molecular biological methods can help T/B classification when wecouldn't get it by phenotyping.

关 键 词：恶性淋巴瘤 预后 基因重排 

分 类 号：R733.4[医药卫生—肿瘤]