Zeng Lin-Shu, Huang Wen-Ting, Qiu Tian, Shan Ling, Guo Lei, Ying Jian-Ming, Lyu Ning, Feng Xiao-Li
Department of Pathology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
Chronic Dis Transl Med. 2017 Dec 13;3(4):252-259. doi: 10.1016/j.cdtm.2017.11.003. eCollection 2017 Dec.
To investigate the correlation between the clinicopathological features and prognosis in patients with extranodal natural killer (NK)/T-cell lymphoma (ENKTCL).
One hundred and four patients diagnosed with ENKTCL at the Department of Pathology, Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, China from November 1991 to September 2011 were included in the study. The clinicopathological features and their correlations with disease prognosis were evaluated in these patients.
The number of effective follow-up cases was 56 (53.8%) by the end of last follow-up in October 2015. Univariate survival analysis showed that granzyme B, perforin, and Bcl-2 expression was significantly associated with a poor prognosis in ENKTCL ( = 0.033, 0.004, and 0.034, respectively), whereas platelet-derived growth factor receptor-alpha (PDGFRA) expression was significantly associated with a better prognosis ( = 0.034). Ki-67 overexpression (≥50%) was significantly associated with a poor prognosis ( = 0.017). Different treatment approaches were also associated with prognosis ( = 0.014); specifically, the efficacies of combination treatments including chemotherapy and radiotherapy, and autologous hematopoietic stem cell transplantation were significantly better than those involving radiotherapy and chemotherapy alone. Patient gender, age, tumor location, staging, the presence of B symptoms, pretreatment lactate dehydrogenase levels, and β2-microglobulin levels were not associated with the prognosis of ENKTCL ( > 0.05). However, multivariate analyses showed that the treatment approach and all the immune markers were not independent prognostic factors for ENKTCL.
Granzyme B, perforin, and Bcl-2 expression and Ki-67 overexpression (≥50%) might be adverse prognostic factors for ENKTCL, whereas PDGFRA-positivity suggested a better disease prognosis. In addition, different treatment approaches might be closely related to patient prognosis.
探讨结外自然杀伤（NK）/T细胞淋巴瘤（ENKTCL）患者临床病理特征与预后的相关性。
纳入1991年11月至2011年9月在中国医学科学院肿瘤医院病理科诊断为ENKTCL的104例患者。对这些患者的临床病理特征及其与疾病预后的相关性进行评估。
截至2015年10月最后一次随访结束时，有效随访病例数为56例（53.8%）。单因素生存分析显示，颗粒酶B、穿孔素和Bcl-2表达与ENKTCL的不良预后显著相关（分别为P = 0.033、0.004和0.034），而血小板衍生生长因子受体α（PDGFRA）表达与较好的预后显著相关（P = 0.034）。Ki-67过表达（≥50%）与不良预后显著相关（P = 0.017）。不同的治疗方法也与预后相关（P = 0.014）；具体而言，包括化疗和放疗以及自体造血干细胞移植的联合治疗的疗效明显优于单纯放疗和化疗。患者的性别、年龄、肿瘤部位、分期、B症状的存在、治疗前乳酸脱氢酶水平和β2-微球蛋白水平与ENKTCL的预后无关（P > 0.05）。然而，多因素分析显示，治疗方法和所有免疫标志物均不是ENKTCL的独立预后因素。
颗粒酶B、穿孔素和Bcl-2表达以及Ki-67过表达（≥50%）可能是ENKTCL的不良预后因素，而PDGFRA阳性提示疾病预后较好。此外，不同的治疗方法可能与患者预后密切相关。
