摘要
目的探讨人类免疫缺陷病毒(HIV)载量、BCL6表达状态对弥漫性大B细胞淋巴瘤(DLBCL)预后的影响。方法回顾性分析本院50例获得性免疫缺陷综合征(AIDS)相关DLBCL患者资料。根据Hans分型分为GCB型组36例,ABC型组14例,基于HIV病毒载量进行分层。采用免疫组织化学Envision法检测两组免疫标记物;采用χ^(2)检验和Fisher精确检验比较组间病理相关变量的差异性。绘制Kaplan-Meier生存曲线并采用Cox多因素回归模型分析AIDS相关DLBCL患者的预后影响因素。结果与ABC型组相比,GCB型组患者免疫组织化学标记物CD10^(+)、BCL6^(+),Ki67≥80%占比升高,MUM1^(+)占比降低(P<0.05)。当HIV-RNA<200 copies/mL时,GCB型组CD10^(+)、BCL6^(+)、Ki67≥80%占比高于ABC型组(P<0.05),MUM1^(+)占比低于ABC型组(P<0.05);当HIV-RNA≥200 copies/mL时,GCB型组CD10^(+)占比高于ABC型组(P<0.05)。BCL6^(+)、HIV<200 copies/mL的患者2年无进展生存率和总生存率分别高于BCL6-、HIV-RNA≥200 copies/mL的患者(P<0.05)。BCL6^(+)、HIV<200 copies/mL是AIDS相关DLBCL预后的保护因素,MUM1^(+)是AIDS相关DLBCL预后的危险因素。结论BCL6^(+)和HIV<200 copies/mL是AIDS相关DLBCL的独立良好预后因素,MUM1^(+)则提示预后不良。
Aim To investigate the impact of human immunodeficiency virus(HIV)viral load and BCL6 expression status on the prognosis of diffuse large B-cell lymphoma(DLBCL).Methods A retrospective analysis was conducted on the data of 50 patients with acquired immunodeficiency syndrome(AIDS)-related DLBCL in our hospital.According to the Hans classification,the cases were divided into the GCB group(n=36)and the ABC group(n=14),with stratification based on HIV viral load.The immunohistochemical Envision method was used to detect immune markers in both groups;Chi-square test and Fisher s exact test were employed to compare the differences in pathology-related variables between the groups.Kaplan-Meier survival curves were plotted and the Cox multivariate regression model was used to analyze prognostic factors in AIDS-related DLBCL patients.Results Compared with the ABC group,the GCB group showed higher proportions of CD10^(+),BCL6^(+),and Ki67≥80%in immunohistochemical markers,while the proportion of MUM1^(+)was lower(P<0.05).When HIV-RNA<200 copies/mL,the proportion of CD10^(+),BCL6^(+),and Ki67≥80%in the GCB group were higher than those in the ABC group(P<0.05),and the proportion of MUM1^(+)was lower than that in the ABC group(P<0.05);When HIV-RNA≥200 copies/mL,the proportion of CD10^(+)in the GCB group was higher than that in the ABC group(P<0.05).The 2-year progression free survival and overall survival rates of patients with BCL6^(+)and HIV<200 copies/mL were higher than those of patients with BCL6-and HIV-RNA≥200 copies/mL,respectively(P<0.05).BCL6^(+)and HIV<200 copies/mL were protective factors for prognosis in AIDS-related DLBCL,while MUM1^(+)was a risk factor for prognosis in AIDS-related DLBCL.Conclusion BCL6^(+)and HIV<200 copies/mL are independent favorable prognostic factors for AIDS-related DLBCL,while MUM1^(+)indicates poor prognosis.
作者
陶婷
陈辉
段智
周训检
余思维
肖政
罗武
曾希
TAO Ting;CHEN Hui;DUAN Zhi;ZHOU Xunjian;YU Siwei;XIAO Zhen;LUO Wu;ZENG Xi(Institute of Oncology,Hengyang Medical School,University of South China,Hengyang 421001,Hunan,China;Department of Pathology,the First Hospital of Changsha,Changsha 410005,Hunan,China;Department of Laboratory Medicine,the First Hospital of Changsha,Changsha 410005,Hunan,China)
出处
《中南医学科学杂志》
2025年第4期617-621,共5页
Medical Science Journal of Central South China
基金
湖南省自然科学基金项目(2024JJ9514,2023JJ30061)
湖南省卫生健康委科研计划项目(B202311008289)
长沙市第一医院基金项目(Y2021-44)。
