Spier C M, Grogan T M, Lippman S M, Slymen D J, Rybski J A, Miller T P
Department of Pathology, University of Arizona College of Medicine, Tucson 85724.
Am J Pathol. 1988 Oct;133(1):118-26.
To assess the prognostic significance of the immunophenotype in diffuse large cell lymphoma (DLCL), 105 DLCL patients were studied between 1978 and 1987 using a panel of 40 monoclonal antibodies applied to frozen tissue. Eighty-three patients were found to have B cell phenotypes, and 20 patients had T cell phenotypes. Focusing on markers relevant to clinical outcome among B cell LCL showed that lack of expression of the pan B antigens Leu14 and Leu16 were correlated with decreased survival (Leu14, P = 0.01; Leu16, P = 0.06; log-rank). HLA-DR activity also showed that lack of expression of this antigen correlated with poor survival (P = 0.004, log-rank). Kappa light chain immunoglobulin lack of expression showed predictive value for decreased survival as well (P = 0.005, log-rank). Multivariate analyses of known clinically important variables and the immune phenotypes confirm that the loss of HLA-DR and B cell aberrancy are independent factors predicting a poor clinical outcome. Losing some B activation/kappa antigens appears to be a broad biologic phenomenon linking surface antigen lack of expression with decreased survival. This suggests that aberrancy of immunophenotype and immunoglobulin status are key predictors of survival in B-LCL.
为评估免疫表型在弥漫性大细胞淋巴瘤（DLCL）中的预后意义，1978年至1987年间，使用一组40种单克隆抗体对105例DLCL患者的冷冻组织进行了研究。发现83例患者具有B细胞表型，20例患者具有T细胞表型。关注B细胞淋巴瘤中与临床结果相关的标志物显示，泛B抗原Leu14和Leu16表达缺失与生存率降低相关（Leu14，P = 0.01；Leu16，P = 0.06；对数秩检验）。HLA-DR活性也显示该抗原表达缺失与不良生存率相关（P = 0.004，对数秩检验）。κ轻链免疫球蛋白表达缺失也显示出对生存率降低的预测价值（P = 0.005，对数秩检验）。对已知的临床重要变量和免疫表型进行多变量分析证实，HLA-DR缺失和B细胞异常是预测不良临床结果的独立因素。某些B激活/κ抗原的缺失似乎是一种广泛的生物学现象，将表面抗原表达缺失与生存率降低联系起来。这表明免疫表型和免疫球蛋白状态的异常是B细胞淋巴瘤生存率的关键预测因素。
