肿瘤相关巨噬细胞、淋巴细胞与单核细胞比值及中性粒细胞与淋巴细胞比值在弥漫性大B细胞淋巴瘤中的预后影响
Prognostic impact of tumor-associated macrophages, lymphocyte-to-monocyte and neutrophil-to-lymphocyte ratio in diffuse large B-cell lymphoma.
作者信息
Cencini Emanuele, Fabbri Alberto, Schiattone Luana, Sicuranza Anna, Mecacci Bianca, Granai Massimo, Mancini Virginia, Lazzi Stefano, Bocchia Monica, Leoncini Lorenzo
机构信息
Unit of Hematology, Azienda Ospedaliera Universitaria Senese & University of Siena Siena, Italy.
Unit of Pathology, Department of Medical Biotechnologies, University of Siena Siena, Italy.
出版信息
Am J Blood Res. 2020 Aug 25;10(4):97-108. eCollection 2020.
INTRODUCTION
Microenvironment has a prognostic influence in diffuse large B-cell lymphoma (DLBCL); among its components, tumor-associated macrophages (TAM) play a leading role. TAM can be classified into M1 (anti-tumor) and M2 (pro-tumor). Another prognostic factor could be represented by lymphocyte-to-monocyte and neutrophil-to-lymphocyte ratio (LMR and NLR).
OBJECTIVE
The aim of the study is to evaluate the prognostic impact of M1 and M2 TAM subtypes, LMR and NLR in DLBCL.
METHODS
We analyzed 37 consecutive patients between 2009 and 2013. Out of 37 patients, 28/37 (75.6%) received R-CHOP/CHOP-like regimens, 9/37 (24.4%) less intensive therapies. Immunohistochemistry was performed with antibodies against CD68 and CD163. We divided our cohort into 2 categories according to the Steidl score. TAM who coexpressed CD68 and CD163 were considered as M2. For LMR and NLR we used previously published cut-offs of 2.71 and 2.81.
RESULTS
CR rate was 70.3%; we did not record a significant correlation between CD68+ TAM, CD163+ TAM, CD68+/CD163+ TAM, LMR, NLR and CR. We observed a reduced PFS in patients with IPI ≥ 2 and high M2 TAM expression and a trend between higher expression of CD68+ TAM and improved PFS.
CONCLUSION
M2 TAM could have a prognostic role for IPI ≥ 2 DLBCL patients receiving R-CHOP, which thus warrants further investigation.
引言
微环境对弥漫性大B细胞淋巴瘤（DLBCL）的预后有影响；在其组成成分中，肿瘤相关巨噬细胞（TAM）起主要作用。TAM可分为M1（抗肿瘤）和M2（促肿瘤）亚型。另一个预后因素可能由淋巴细胞与单核细胞比值及中性粒细胞与淋巴细胞比值（LMR和NLR）表示。
目的
本研究旨在评估M1和M2 TAM亚型、LMR和NLR对DLBCL的预后影响。
方法
我们分析了2009年至2013年间连续的37例患者。37例患者中，28/37（75.6%）接受了R-CHOP/类CHOP方案治疗，9/37（24.4%）接受了强度较低的治疗。使用抗CD68和CD163抗体进行免疫组织化学检测。根据施泰德尔评分将我们的队列分为2类。共表达CD68和CD163的TAM被视为M2。对于LMR和NLR，我们使用先前公布的临界值2.71和2.81。
结果
完全缓解率为70.3%；我们未发现CD68+ TAM、CD163+ TAM、CD68+/CD163+ TAM、LMR、NLR与完全缓解之间存在显著相关性。我们观察到国际预后指数（IPI）≥2且M2 TAM高表达的患者无进展生存期缩短，以及CD68+ TAM高表达与无进展生存期改善之间存在一种趋势。
结论
M2 TAM可能对接受R-CHOP治疗的IPI≥2的DLBCL患者具有预后作用，因此值得进一步研究。
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