应用免疫组织化学进行细胞起源分析在预测印度尼西亚弥漫性大B细胞淋巴瘤患者生存中的作用
Role of Cell-Origin Profiling Using Immunohistochemistry to Predict the Survival of Patients with Diffuse Large B-Cell Lymphoma in Indonesia.
作者信息
Istiadi Hermawan, Sadhana Udadi, Puspasari Dik, Miranti Ika Pawitra, Karlowee Vega, Listiana Devia Eka, Prasetyo Awal
机构信息
Anatomical Pathology Department, Faculty of Medicine, Diponegoro University, Semarang 50244, Indonesia.
Anatomical Pathology Laboratory, Kariadi General Hospital, Semarang 50244, Indonesia.
出版信息
Yonago Acta Med. 2021 May 20;64(2):200-206. doi: 10.33160/yam.2021.05.014. eCollection 2021 May.
BACKGROUND
Diffuse large B-cell lymphoma (DLBCL) is the most common type of non-Hodgkin lymphoma in Asia and Indonesia. DLBCL could be further classified according to cell of origin as the germinal center B-cell (GCB) subtype or the non-germinal center B-cell (non-GCB) subtypes; of these, the non-GCB subtype usually has poorer prognosis. The purpose of this study is to determine the relationship between the cell-origin subtype and 3-year overall survival of patients with DLBCL at Kariadi General Hospital Semarang.
METHODS
This research represents an observational analytical study of 36 patients with DLBCL who visited Kariadi General Hospital between January and August 2017. Data on age of diagnosis, tumor location, disease stage, and 3-year overall survival were collected. DLBCL subtype was determined via immunohistochemical examination of CD10, BCL6, and MUM1 protein expression. Data analyses, including the chi squared test and Kaplan-Meier curves, were conducted.
RESULTS
The study population included 18 patients with GCB-subtype DLBCL and 18 patients with non-GCB-subtype DLBCL. No significant difference ( = 0.171) between disease stage and cell-origin subtype was noted between groups. Patients with the non-GCB subtype had a 3-year overall survival that was significantly worse than that of patients with the GCB subtype ( = 0.026). Moreover, the 3-year survival rate of patients with the non-GCB subtype of the disease was 38.9% while that of patients with the GCB subtype was 77.8%. Patients with advanced stages of DLBCL also had a 3-year overall survival that was significantly worse than those of patients with early stages of the disease ( < 0.001), with the 3-year survival rate of patients with advanced stage was 14.3%.
CONCLUSION
Patients with non-GCB-subtype DLBCL or advanced stages of the disease have a lower 3-year overall survival rate and poorer prognosis compared with those with other subtypes or earlier stages of the disease.
背景
弥漫性大B细胞淋巴瘤（DLBCL）是亚洲和印度尼西亚最常见的非霍奇金淋巴瘤类型。DLBCL可根据细胞起源进一步分为生发中心B细胞（GCB）亚型或非生发中心B细胞（非GCB）亚型；其中，非GCB亚型通常预后较差。本研究的目的是确定三宝垄卡里阿迪综合医院DLBCL患者的细胞起源亚型与3年总生存率之间的关系。
方法
本研究是一项对2017年1月至8月间就诊于卡里阿迪综合医院的36例DLBCL患者的观察性分析研究。收集了诊断年龄、肿瘤位置、疾病分期和3年总生存率的数据。通过对CD10、BCL6和MUM1蛋白表达进行免疫组化检查来确定DLBCL亚型。进行了包括卡方检验和Kaplan-Meier曲线在内的数据分析。
结果
研究人群包括18例GCB亚型DLBCL患者和18例非GCB亚型DLBCL患者。两组之间疾病分期与细胞起源亚型之间未发现显著差异（P = 0.171）。非GCB亚型患者的3年总生存率明显低于GCB亚型患者（P = 0.026）。此外，该疾病非GCB亚型患者的3年生存率为38.9%，而GCB亚型患者为77.8%。DLBCL晚期患者的3年总生存率也明显低于疾病早期患者（P < 0.001），晚期患者的3年生存率为14.3%。
结论
与其他亚型或疾病早期患者相比，非GCB亚型DLBCL患者或疾病晚期患者的3年总生存率较低，预后较差。
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