Zhou Ying, Zhao Yu, Bo Jian, Li Yan-Fen, Ma Chao, Shi Ya-Nan
Department of Hematology, Chinese PLA General hospital, Beijing 100853.
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2013 Oct;21(5):1162-6. doi: 10.7534/j.issn.1009-2137.2013.05.015.
This study was aimed to evaluate the proliferation-associated antigen Ki-67 expression in diffuse large B cell lymphoma (DLBCL) and its clinical significance. The Ki-67 expression and its correlation with prognosis in 50 patients with DLBCL treated with rituximab plus CHOP (R-CHOP) between January 2008 and December 2010 were analyzed retrospectively. The results indicated that there was no significant relationship between Ki-67 expression and clinical features, including age, sex, staging, B symptoms, LDH level, IPI, extranodal site involvement, presence of bulky tumors (>10 cm in diameter), bone marrow involvement, GCG nor GCB type, or response to first line treatment. The median survival was 50 months and 15 months in low Ki-67 expression group (<85%) and in high Ki-67 expression group ( ≥ 85%) respectively. The overall survival (OS) and progress-free survival (PFS) in low Ki-67 expression group were obviously longer than that in high Ki-67 expression group (P = 0.001; P = 0.027). In univariate analysis, the clinical factors associated with OS included Ann Arbor staging and Ki-67 expression. The clinical factors associated with PFS included Ann Arbor staging. IPI and Ki-67 expression. In multivariate analysis. The Ki-67 expression level was an independent prognostic factor for OS (HR = 4.90; 95% CI, 1.456-16.511; P = 0.0103). It is concluded that Ki-67 expression level seems to be an effective marker for evaluation of DLBCL prognosis.
本研究旨在评估增殖相关抗原Ki-67在弥漫性大B细胞淋巴瘤(DLBCL)中的表达及其临床意义。回顾性分析了2008年1月至2010年12月期间接受利妥昔单抗联合CHOP(R-CHOP)治疗的50例DLBCL患者的Ki-67表达情况及其与预后的相关性。结果表明,Ki-67表达与临床特征之间无显著关系,这些临床特征包括年龄、性别、分期、B症状、乳酸脱氢酶(LDH)水平、国际预后指数(IPI)、结外部位受累情况、巨大肿瘤(直径>10 cm)的存在、骨髓受累情况、生发中心型(GCG)或非生发中心型(GCB),以及对一线治疗的反应。低Ki-67表达组(<85%)和高Ki-67表达组(≥85%)的中位生存期分别为50个月和15个月。低Ki-67表达组的总生存期(OS)和无进展生存期(PFS)明显长于高Ki-67表达组(P = 0.001;P = 0.027)。单因素分析显示,与OS相关的临床因素包括Ann Arbor分期和Ki-67表达。与PFS相关的临床因素包括Ann Arbor分期、IPI和Ki-67表达。多因素分析显示,Ki-67表达水平是OS的独立预后因素(风险比[HR]=4.90;95%可信区间[CI],1.456 - 16.511;P = 0.0103)。结论是,Ki-67表达水平似乎是评估DLBCL预后的有效标志物。