Huang Ying, Ye Sheng, Cao Yabing, Li Zhiming, Huang Jiajia, Huang He, Cai Muyan, Luo Rongzhen, Lin Tongyu
State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou 510060, China.
ScientificWorldJournal. 2012;2012:897178. doi: 10.1100/2012/897178. Epub 2012 Nov 4.
Diffuse large B-cell lymphoma (DLBCL) can be molecularly subtyped as either germinal center B-cell (GCB) or non-GCB. The role of rituximab(R) in these two groups remains unclear. We studied 204 patients with de novo DLBCL (107 treated with first-line CHOP; 97 treated with first-line R-CHOP), patients being stratified into GCB and non-GCB on the basis of BCL-6, CD10, and MUM1 protein expression. The relationships between clinical characteristics, survival data, and immunophenotype (IHC) were studied. The 5-year overall survival (OS) in the CHOP and R-CHOP groups was 50.4% and 66.6% (P = 0.031), respectively. GCB patients had a better 5-year OS than non-GCB patients whether treated with CHOP or not (65.0% versus 40.9%; P = 0.011). In contrast, there is no difference in the 5-year OS for the GCB and non-GCB with R-CHOP (76.5% versus 61.3%; P = 0.141). In non-GCB subtype, additional rituximab improved survival better than CHOP (61.3% versus 40.9%; P = 0.0303). These results indicated that addition of rituximab to standard chemotherapy eliminates the prognostic value of IHC-defined GCB and non-GCB phenotypes in DLBCL by improving the prognostic value of non-GCB subtype of DLBCL.
弥漫性大B细胞淋巴瘤（DLBCL）在分子水平上可分为生发中心B细胞（GCB）型或非GCB型。利妥昔单抗（R）在这两组中的作用仍不明确。我们研究了204例初治DLBCL患者（107例接受一线CHOP治疗；97例接受一线R-CHOP治疗），根据BCL-6、CD10和MUM1蛋白表达将患者分为GCB型和非GCB型。研究了临床特征、生存数据和免疫表型（免疫组化）之间的关系。CHOP组和R-CHOP组的5年总生存率（OS）分别为50.4%和66.6%（P = 0.031）。无论是否接受CHOP治疗，GCB型患者的5年OS均优于非GCB型患者（65.0%对40.9%；P = 0.011）。相比之下，接受R-CHOP治疗的GCB型和非GCB型患者的5年OS无差异（76.5%对61.3%；P = 0.141）。在非GCB亚型中，加用利妥昔单抗比CHOP更能提高生存率（61.3%对40.9%；P = 0.0303）。这些结果表明，在标准化疗中添加利妥昔单抗可通过提高DLBCL非GCB亚型的预后价值，消除免疫组化定义GCB和非GCB表型在DLBCL中的预后价值。
