Peng Fang, Guo Liang, Yao Wei-Kai, Zheng Yan, Liu Ye, Duan Xiu-Mei, Wang Yin-Ping
Department of Pathology, The First Hospital of Jilin University, Changchun, China.
Indian J Pathol Microbiol. 2017 Jan-Mar;60(1):87-91. doi: 10.4103/0377-4929.200056.
To identify prognostic factors for patients with diffuse large B-cell lymphoma (DLBCL), specifically those classified into conflicting subgroups by Hans' and Choi's classification algorithms. We retrospectively reviewed clinical and pathological data of 154 patients diagnosed with de novo DLBCL in the First Hospital of Jilin University from January 2004 to September 2011. All cases were classified into subgroups based on Hans' and Choi's algorithms with immunohistochemical markers.
The correlation between various clinicopathological factors and 5-year survival rate, the correlation between those factors with the International Prognostic Index, the concordance between Hans' and Choi's approach was evaluated. The survival in different subtypes as classified by Hans' or Choi's approach was mapped.
The Eastern Cooperative Oncology Group (ECOG) performance score 2-5, positive Bcl-2 expression, negative CD10 expression or negative Bcl-6 expression significantly correlated with worse prognosis. The two algorithms showed good consistency (83% concordance, Kappa = 0.660, P < 0.001). By both classifications, the 5-year overall survival rate in germinal center B-cell-like subtype (GCB) lymphoma is significantly higher than that in the non-GCB subtype. There were 25 cases assigned to conflicting subtypes by the two approaches. Among these 25 cases, ECOG 2-5, positive Bcl-2 expression, negative CD10 expression, or negative Bcl-6 expression significantly correlated with worse prognosis.
ECOG 2-5, positive Bcl-2 expression, negative CD10 expression, or negative Bcl-6 expression are independent markers for poor prognosis of DLBCL patients. There were 15% cases assigned to conflicting subgroups based on the two algorithms. For these cases, ECOG 2-5, positive Bcl-2 expression, negative CD10 expression, or negative Bcl-6 expression still significantly correlate with poor prognosis.
为确定弥漫性大B细胞淋巴瘤（DLBCL）患者的预后因素，特别是那些根据汉斯和崔氏分类算法被归类到相互矛盾亚组的患者。我们回顾性分析了2004年1月至2011年9月在吉林大学第一医院确诊为初发性DLBCL的154例患者的临床和病理数据。所有病例均根据汉斯和崔氏算法，采用免疫组化标记物进行亚组分类。
评估各种临床病理因素与5年生存率之间的相关性、这些因素与国际预后指数之间的相关性、汉斯和崔氏方法之间的一致性。绘制了根据汉斯或崔氏方法分类的不同亚型的生存情况。
东部肿瘤协作组（ECOG）体能状态评分为2 - 5分、Bcl - 2表达阳性、CD10表达阴性或Bcl - 6表达阴性与较差的预后显著相关。两种算法显示出良好的一致性（一致性为83%，Kappa = 0.660，P < 0.001）。通过两种分类方法，生发中心B细胞样亚型（GCB）淋巴瘤的5年总生存率显著高于非GCB亚型。有25例患者被两种方法归类到相互矛盾的亚型。在这25例患者中，ECOG 2 - 5分、Bcl - 2表达阳性、CD10表达阴性或Bcl - 6表达阴性与较差的预后显著相关。
ECOG 2 - 5分、Bcl - 2表达阳性、CD10表达阴性或Bcl - 6表达阴性是DLBCL患者预后不良的独立标志物。基于两种算法，有15%的病例被归类到相互矛盾的亚组。对于这些病例，ECOG 2 - 5分、Bcl - 2表达阳性、CD10表达阴性或Bcl - 6表达阴性仍与不良预后显著相关。
