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GCB 型是原发性中枢神经系统弥漫性大 B 细胞淋巴瘤的有利预后因素。

GCB-type is a favorable prognostic factor in primary CNS diffuse large B-cell lymphomas.

机构信息

Department of Pathology, Beth Israel Deaconess Medical Center, 330 Brookline Ave., Boston, MA 02215, United States; Harvard Medical School, 25 Shattuck St., Boston, MA 02115, United States.

Department of Surgery, Beth Israel Deaconess Medical Center, 330 Brookline Ave., Boston, MA 02215, United States.

出版信息

J Clin Neurosci. 2021 Jan;83:49-55. doi: 10.1016/j.jocn.2020.11.031. Epub 2020 Dec 16.

Abstract

Primary CNS lymphomas (PCNSLs) are aggressive diffuse large B-cell lymphomas (DLBCLs) limited to the CNS that generally have a poor prognosis. Classification of DLBCL into germinal center B-cell (GCB) and activated B-cell (non-GCB) subtypes has prognostic value in systemic DLBCL, with GCB-type having a better prognosis. The aim of this study was to determine whether GCB versus non-GCB classification in PCNSLs has similar prognostic value. We analyzed clinical, radiological and histologic data from 24 patients with biopsy confirmed DLBCL of the CNS with classification into GCB versus non-GCB subtypes. We found that after a median follow-up of 15 months, only 39% of patients with non-GCB-type PCNS DLBCL were alive, whereas all patients with GCB-type were alive. Non-GCB-type had a median survival of 11 months, whereas all GCB-type patients were alive after a median follow-up of 22 months. As previously reported, we also found that patients younger than 70 years had longer survival (median 29 months) compared to older patients (median 8.8 months). There was no statistically significant difference between the ages, gender, focality, size or location of lesions, or treatment of non-GCB and GCB-type patients. Our findings suggest that classifying PCNSLs into GCB versus non-GCB subtype using the Hans algorithm may help stratify patients into two groups with different prognosis.

摘要

原发性中枢神经系统淋巴瘤(PCNSL)是局限于中枢神经系统的侵袭性弥漫性大 B 细胞淋巴瘤(DLBCL),通常预后较差。在系统性 DLBCL 中,将 DLBCL 分为生发中心 B 细胞(GCB)和活化 B 细胞(非 GCB)亚型具有预后价值,GCB 型具有更好的预后。本研究旨在确定 PCNSLs 中 GCB 与非 GCB 分类是否具有相似的预后价值。我们分析了 24 例经活检证实的中枢神经系统弥漫性大 B 细胞淋巴瘤患者的临床、影像学和组织学数据,并对其进行了 GCB 与非 GCB 亚型分类。我们发现,在中位随访 15 个月后,非 GCB 型 PCNSL DLBCL 患者仅有 39%存活,而所有 GCB 型患者均存活。非 GCB 型患者的中位生存时间为 11 个月,而所有 GCB 型患者在中位随访 22 个月后均存活。与之前的报道一致,我们还发现,年龄小于 70 岁的患者生存时间更长(中位 29 个月),而年龄较大的患者(中位 8.8 个月)则较短。非 GCB 和 GCB 型患者在年龄、性别、局灶性、病变大小或位置以及治疗方面均无统计学差异。我们的研究结果表明,使用 Hans 算法将 PCNSLs 分为 GCB 与非 GCB 亚型可能有助于将患者分为预后不同的两组。

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