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血管免疫母细胞性 T 细胞淋巴瘤:31 例患者初始治疗与微血管密度的影响。

Angioimmunoblastic T-cell lymphoma: the effect of initial treatment and microvascular density in 31 patients.

机构信息

Department of Medical Oncology, The Third Affiliated Hospital of Harbin Medical University, Haping Road 150 of Nangang District, Harbin, Heilongjiang Province, 150081, China.

出版信息

Med Oncol. 2012 Dec;29(4):2311-6. doi: 10.1007/s12032-011-0094-7. Epub 2011 Oct 30.

Abstract

The objectives of this study are to explore the clinical features and treatment outcomes and to investigate the correlation between microvessel density (MVD) and survival in patients with angioimmunoblastic T-cell lymphoma (AITL). We retrospectively analyzed clinical and follow-up data of 31 patients treated in two hospitals during 1995-2009 histologically proven AITL. We also assessed MVD in the lump of 31 previously untreated patients using α-CD34 immunohistochemical staining. The median age of the 31 patients was 48 years, eighty percent of the patients were in an advanced stage. 67.7% of them had B symptoms, with the follow-up of 2-13 years, the 5-year overall survival rate was 25.8%. The response rates (RR) of CHOP group and COP (cyclophosphamide, vincristine and prednisolone) group are 76.5 and 75%, respectively, which is no significant difference (P=0.894). RR did not differ whether chemotherapy regimens contained anthracycline or not. The 3-year PFS rate for patients who received COP and CHOP regimen was 25.4 and 35.3% (P=0.562), while 5-year OS rates were 25.0 and 29.4%, respectively (P=0.667). The median PFS for patients with high MVD and low MVD were 15.1 and 30.0 months (P=0.048), while the median OS were 20 and 45 months, respectively (P=0.038). Patients who were sensitive to initial chemotherapy COP regimen have the similar therapeutic effect to CHOP regimen. Patients with high MVD measured in the microenvironment had worse PFS and OS than AITL patients with low expression.

摘要

本研究旨在探讨血管免疫母细胞性 T 细胞淋巴瘤(AITL)患者的临床特征、治疗效果及微血管密度(MVD)与生存的相关性。我们回顾性分析了 1995 年至 2009 年期间在两家医院经组织学证实的 31 例 AITL 患者的临床和随访资料。我们还使用α-CD34 免疫组化染色评估了 31 例未经治疗的患者肿块中的 MVD。31 例患者的中位年龄为 48 岁,80%的患者处于晚期。67.7%的患者有 B 症状,随访时间为 2-13 年,5 年总生存率为 25.8%。CHOP 组和 COP(环磷酰胺、长春新碱和泼尼松)组的缓解率(RR)分别为 76.5%和 75%,差异无统计学意义(P=0.894)。化疗方案中是否包含蒽环类药物对 RR 无影响。接受 COP 和 CHOP 方案治疗的患者 3 年 PFS 率分别为 25.4%和 35.3%(P=0.562),5 年 OS 率分别为 25.0%和 29.4%(P=0.667)。MVD 高和 MVD 低的患者中位 PFS 分别为 15.1 和 30.0 个月(P=0.048),中位 OS 分别为 20 和 45 个月(P=0.038)。对初始 COP 化疗方案敏感的患者与接受 CHOP 方案治疗的患者具有相似的治疗效果。在微环境中测量到高 MVD 的患者的 PFS 和 OS 比低表达的 AITL 患者差。

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