B细胞分化标志对原发中枢神经系统淋巴瘤预后的影响
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摘要
目的:探讨B细胞分化标志在119例原发中枢神经系统淋巴瘤患者预后评估中的价值。方法:采用免疫组织化学法测定BCL-2、BCL-6、CD10、MUM1/IRF4蛋白的表达,分析它们与原发中枢神经系统淋巴瘤预后的关系。结果:单因素分析显示,BCL-6+意味着更短的PFS(P=0.047)与OS(P=0.035)。多因素分析显示,BCL-6+意味着更短的PFS(HR:1.95,95%CI:1.22-3.12,P=0.005),但与OS不相关(HR:1.85,95%CI:0.71-4.8,P=0.21)。Hans分类及单个B细胞标记BCL-2、CD10、Mum1/IRF4与预后不相关。结论:BCL-6+是PCNSL的不良预后标记。
Objective: To investigate the value of B-cell differentiation markers in prognosis evaluation of 119 patients with primary CNS lymphoma(PCNSL). Methods: The expressions of BCL-2,BCL-6,CD10 and MUM1/IRF4 protein were determined by immunohistochemistry,and their relationship with the prognosis of primary central nervous system lymphoma was analyzed. Results: Univariate analysis showed that BCL-6 positive means shorter PFS(P= 0. 047) and OS(P = 0. 035). Multivariate analysis showed that BCL-6 positive expression was related with shorter PFS(hazard ratio:1. 95,95% CI: 1. 22-3. 12,P = 0. 005),but did not relate with OS( hazard ratio: 1. 85,95%CI: 0. 71-4. 80,P = 0. 21). Classification based on Hans algorithm and expression status of the single B-cell markers BCL-2,CD10 and MUM1/IRF4 did not correlate with prognosis. Conclusion: BCL-6 may be an unfavorable prognostic biomarker for PCNSL.
Objective: To investigate the value of B-cell differentiation markers in prognosis evaluation of 119 patients with primary CNS lymphoma(PCNSL). Methods: The expressions of BCL-2,BCL-6,CD10 and MUM1/IRF4 protein were determined by immunohistochemistry,and their relationship with the prognosis of primary central nervous system lymphoma was analyzed. Results: Univariate analysis showed that BCL-6 positive means shorter PFS(P= 0. 047) and OS(P = 0. 035). Multivariate analysis showed that BCL-6 positive expression was related with shorter PFS(hazard ratio:1. 95,95% CI: 1. 22-3. 12,P = 0. 005),but did not relate with OS( hazard ratio: 1. 85,95%CI: 0. 71-4. 80,P = 0. 21). Classification based on Hans algorithm and expression status of the single B-cell markers BCL-2,CD10 and MUM1/IRF4 did not correlate with prognosis. Conclusion: BCL-6 may be an unfavorable prognostic biomarker for PCNSL.
引文
1 Korfel A,Schlegel U.Diagnosis and treatment of primary CNS lymphoma.Nat Rev Neurol,2013;9(6):317-327.
2 孙永城,朱慧玲,赖斌斌,等.大剂量甲氨蝶呤为主的联合化疗方案治疗原发性中枢神经系统淋巴瘤的临床分析.现代实用医学,2015;27(3):313-314.
3 Abrey LE,Yahalom J,De Angelis LM.Treatment for primary CNS lymphoma:the next step.Clin Oncol,2000;18(17):3144-3150.
4 Camilleri-Broet S,Criniere E,Broet P,et al.A uniform activated Bcell-like immunophenotype might explain the poor prognosis of primary central nervous system lymphomas:analysis of 83 cases.Blood,2006;107(1):190-196.
5 Preusser M,Woehrer A,Koperek O,et al.Primary central nervous system lymphoma:a clinicopathological study of 75 cases.Pathology,2010;42(6):547-552.
6 Lin CH,Kuo KT,Chuang SS,et al.Comparison of the expression and prognostic significance of differentiation markers between diffuse large B-cell lymphoma of central nervous system origin and peripheral nodal origin.Clin Cancer Res,2006;12(4):1152-1156.
7 Levy O,Deangelis LM,Filippa DA,et al.Bcl-6 predicts improved prognosis in primary central nervous system lymphoma.Cancer,2008;112(1):151-156.
8 Camilleri-Broet S,Criniere E,Broet P,et al.A uniform activated Bcell-like immunophenotype might explain the poor prognosis of primary central nervous system lymphomas:analysis of 83 cases.Blood,2006;107(1):190-196.
9 Mounier N,Briere J,Gisselbrecht C,et al.Rituximab plus CHOP(R-CHOP)overcomes bcl-2-associated resistance to chemotherapy in elderly patients with diffuse large B-cell lymphoma(DLBCL).Blood,2003;101(11):4279-4284.
10 Gascoyne RD,Adomat SA,Krajewski S,et al.Prognostic significance of Bcl-2 protein expression and Bcl-2 gene rearrangement in diffuse aggressive non-Hodgkin's lymphoma.Blood,1997;90(1):244-251.
11 杨华,候文,冉丰丰,等.韦氏环原发弥漫性大B细胞淋巴瘤分子分型的研究.遵义医学院学报,2011;34(4):348-353.
12 Braaten KM,Betensky RA,de Leval L,et al.BCL-6 expression predicts improved survival in patients with primary central nervous system lymphoma.Clin Cancer Res,2003;9(3):1063-1069.
13 Lossos C,Bayraktar S,Weinzierl E,et al.LMO2 and BCL6 are associated with improved survival in primary central nervous system lymphoma.Br J Haematol,2014;165(5):640-648.
14 Momota H,Narita Y,Maeshima AM,et al.Prognostic value of immunohistochemical profile and response to high-dose methotrexate therapy in primary CNS lymphoma.Neurooncol,2010;98(3):341-348.
15 Raoux D,Duband S,Forest F,et al.Primary central nervous system lymphoma:immunohistochemical profile and prognostic significance.Neuropathology,2010;30(3):232-240.
2 孙永城,朱慧玲,赖斌斌,等.大剂量甲氨蝶呤为主的联合化疗方案治疗原发性中枢神经系统淋巴瘤的临床分析.现代实用医学,2015;27(3):313-314.
3 Abrey LE,Yahalom J,De Angelis LM.Treatment for primary CNS lymphoma:the next step.Clin Oncol,2000;18(17):3144-3150.
4 Camilleri-Broet S,Criniere E,Broet P,et al.A uniform activated Bcell-like immunophenotype might explain the poor prognosis of primary central nervous system lymphomas:analysis of 83 cases.Blood,2006;107(1):190-196.
5 Preusser M,Woehrer A,Koperek O,et al.Primary central nervous system lymphoma:a clinicopathological study of 75 cases.Pathology,2010;42(6):547-552.
6 Lin CH,Kuo KT,Chuang SS,et al.Comparison of the expression and prognostic significance of differentiation markers between diffuse large B-cell lymphoma of central nervous system origin and peripheral nodal origin.Clin Cancer Res,2006;12(4):1152-1156.
7 Levy O,Deangelis LM,Filippa DA,et al.Bcl-6 predicts improved prognosis in primary central nervous system lymphoma.Cancer,2008;112(1):151-156.
8 Camilleri-Broet S,Criniere E,Broet P,et al.A uniform activated Bcell-like immunophenotype might explain the poor prognosis of primary central nervous system lymphomas:analysis of 83 cases.Blood,2006;107(1):190-196.
9 Mounier N,Briere J,Gisselbrecht C,et al.Rituximab plus CHOP(R-CHOP)overcomes bcl-2-associated resistance to chemotherapy in elderly patients with diffuse large B-cell lymphoma(DLBCL).Blood,2003;101(11):4279-4284.
10 Gascoyne RD,Adomat SA,Krajewski S,et al.Prognostic significance of Bcl-2 protein expression and Bcl-2 gene rearrangement in diffuse aggressive non-Hodgkin's lymphoma.Blood,1997;90(1):244-251.
11 杨华,候文,冉丰丰,等.韦氏环原发弥漫性大B细胞淋巴瘤分子分型的研究.遵义医学院学报,2011;34(4):348-353.
12 Braaten KM,Betensky RA,de Leval L,et al.BCL-6 expression predicts improved survival in patients with primary central nervous system lymphoma.Clin Cancer Res,2003;9(3):1063-1069.
13 Lossos C,Bayraktar S,Weinzierl E,et al.LMO2 and BCL6 are associated with improved survival in primary central nervous system lymphoma.Br J Haematol,2014;165(5):640-648.
14 Momota H,Narita Y,Maeshima AM,et al.Prognostic value of immunohistochemical profile and response to high-dose methotrexate therapy in primary CNS lymphoma.Neurooncol,2010;98(3):341-348.
15 Raoux D,Duband S,Forest F,et al.Primary central nervous system lymphoma:immunohistochemical profile and prognostic significance.Neuropathology,2010;30(3):232-240.