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目的探讨弥漫大 B 细胞淋巴瘤(DLBCL)的免疫表型之生发中心 B 细胞样(GCB)和非 GCB 两个亚型的特征及其与 DLBCL 预后的关系。方法根据肿瘤细胞免疫组织化学 EnVision 法标记 CD10、bcl-6、MUM-1的表达情况,将133例 DLBCL 分为 GCB 和非 GCB 两个亚型。对以下指标的5年总生存率(OS)及5年无进展生存率(PFS)进行了比较:(1)CD10、bcl-6和 MUM-1的阳性和阴性病例;(2)GCB 亚型与非 GCB 亚型;(3)不同国际预后指数(IPI)分组中 GCB 亚型与非 GCB 亚型的关系。结果 133例 DLBCL 中,44例(33.1%)CD10阳性,48例(34.6%)bcl-6阳性,60例(45.1%)MUM-1阳性。CD10阳性 DLBCL 患者的5年 OS 及 PFS 均明显高于 CD10阴性患者(P=0.041和0.031);bcl-6阳性 DLBCL 患者的 PFS 明显高于 bcl-6阴性患者(P=0.044),MUM-1阳性 DLBCL 患者的5年 OS 及 PFS 均明显低于 MUM-1阴性患者(P=0.031和0.028)。GCB 型54例(40.6%),非GCB 型79例(59.4%)。GCB 型5年 OS 及 PFS 均明显高于非 GCB 型(P=0.004和0.003)。国际预后指数(IPI)0～1分组及2～5分组中,GCB 型5年 OS 及 PFS 均明显高于非 GCB 型(IPI 0～1分组P=0.019和0.014,2～5分组 P=0.006和0.009),其中 IPI 2～5分组中的非 GCB 预后最差。结论 DLBCL 亚型及其与 IPI 联合分析可以作为预测患者预后的有效指标。
Objective To investigate the characteristics of immunoblotted germ cell B-cell-like (GCB) and non-GCB subtypes of diffuse large B-cell lymphoma (DLBCL) and their relationship with the prognosis of DLBCL. Methods According to the expression of CD10, bcl-6 and MUM-1 by EnVision immunohistochemistry, 133 cases of DLBCL were divided into two subtypes: GCB and non-GCB. The 5-year overall survival (OS) and 5-year progression-free survival (PFS) were compared for the following indicators: (1) positive and negative cases of CD10, bcl-6 and MUM-1; And non-GCB subtypes; (3) the relationship between GCB subtypes and non-GCB subtypes in different international prognostic index (IPI) subgroups. Results Among the 133 cases of DLBCL, 44 (33.1%) were positive for CD10, 48 (34.6%) were positive for bcl-6 and 60 (45.1%) were positive for MUM-1. The 5-year OS and PFS of CD10-positive DLBCL patients were significantly higher than those of CD10-negative patients (P = 0.041 and 0.031). The PFS of patients with bcl-6 positive DLBCL was significantly higher than that of patients with bcl-6 negative The 5-year OS and PFS of positive DLBCL patients were significantly lower than those of MUM-1 negative patients (P = 0.031 and 0.028). 54 cases (40.6%) of GCB type and 79 cases (59.4%) of non-GCB type. The 5-year OS and PFS of GCB were significantly higher than those of non-GCB (P = 0.004 and 0.003). In the international prognostic index (IPI) groups 0 to 1 and 2 to 5, GCB type 5-year OS and PFS were significantly higher than non-GCB type (P = 0.019 and 0.014 in IPI 0-1 group, P = 0.006 And 0.009), of which the non-GCB prognosis in the IPI 2-5 group was the worst. Conclusions DLBCL subtype and its combined analysis with IPI can be used as effective indicators to predict the prognosis of patients.