摘要
目的 了解我国肠道T细胞淋巴瘤 (ITCL)的预后情况 ,探讨不同临床病理因素和EB病毒基因产物对其预后的影响 ,以期寻找确切的预后指标。方法 收集 4 2例ITCL ,运用免疫组织化学LSAB法染色观察CD4、CD8、CD4 5RO、CD5 6、TIA 1和EB病毒潜伏膜蛋白 (LMP 1)的表达 ,采用聚合酶链反应 (PCR)检测TCR γ基因重排扩增 ,运用EBER1/2原位杂交检测EB病毒感染。收集全部 4 2例ITCL的临床资料并进行随访。应用SPSS10 0软件分析临床病理、免疫表型及EB病毒基因产物各项指标与治疗及生存率曲线的关系。结果 (1) 4 2例ITCL中有随访结果者 2 9例 (6 9% )。存活 6例 ,最长存活时间 15 6个月 (13年 )。死亡 2 3例 ,其中复发 4例 ,存活时间 0 3～ 2 4 3个月 ,存活时间中位数3 0个月 ,1年生存率和 2年生存率分别为 30 %和 2 2 %。 (2 )在病灶为单发或多发 ,患者是否出现发热、便血、肠穿孔、淋巴结转移等临床表现 ,肿瘤细胞是否表达CD4、CD8、CD5 6、LMP 1,有无TCR γ基因重排、手术治疗后是否合并化疗或放疗等其他治疗方法各因素中 ,除TCR γ基因重排 (P =0 0 0 78,)和不同的治疗方法 (P =0 0 2 5 0 )外 ,其他各因素与预后不相关。 (3)没有发现有意义的预后因素。结论 肠道T细胞淋巴瘤临床进程凶猛。
Objective To investigate the roles of different clinicopathological features and expression of EBV genome in prognosis of intestinal T cell lymphoma(ITCL) Methods Polymerase chain reaction for TCR γ gene rearrangement, in situ hybridization for EBER1/2 and immunohistochemical staining for CD4, CD8, CD45RO, CD56, TIA 1 were investigated and all patients followed up The LMP 1 expression was determined in forty two ITCLs cases The relationship between clinical data, different clinicopathological features, expression of EBV genome and prognosis were analyzed by SPSS10 0 program Results (1) All 42 cases of ITCL had an extremely poor prognosis with a median survival of 3 0 months,of which the one year survival rate and two year survival rate being 30% and 22% respectively (2) The patients without TCR γ gene rearrangements showed poorer prognosis than those with TCR γ gene rearrangements, and the patients who received operation and chemotherapy showed better prognosis than those who only received operation ( P <0 05) (3) No significant prognostic factor for ITCLs was determined Conclusion The special clinicopathological features of ITCL could be due to the cytotoxic function and the role of EBV infection in the pathogenesis of ITCL
出处
《中华病理学杂志》
CAS
CSCD
北大核心
2002年第4期295-299,共5页
Chinese Journal of Pathology
基金
国家自然科学基金资助项目 (3 9770 2 98)
美国中华医学基金 (CMB)资助项目 (0 0 72 2 )
