黏附分子ICAM-1在非霍奇金淋巴瘤中的表达：与肿瘤播散的关系及预后意义。

Expression of the adhesion molecule ICAM-1 in non-Hodgkin's lymphoma: relationship with tumor dissemination and prognostic importance.

作者信息

Terol M J, López-Guillermo A, Bosch F, Villamor N, Cid M C, Rozman C, Campo E, Montserrat E

机构信息

Postgraduate School of Hematology Farreras Valenti, and Department of Internal Medicine, Hospital Clinic of Barcelona, Spain.

出版信息

J Clin Oncol. 1998 Jan;16(1):35-40. doi: 10.1200/JCO.1998.16.1.35.

DOI:10.1200/JCO.1998.16.1.35

PMID:9440720

Abstract

PURPOSE

To study the expression of intercellular adhesion molecule-1 (ICAM-1) by non-Hodgkin's lymphomas and to assess its correlation with disease extension and prognosis.

PATIENTS AND METHODS

ICAM-1 (CD54-IOL54) expression was studied in 70 patients (35 male/35 female; median age, 56 years) with non-Hodgkin's lymphoma from a single institution. Immunostaining was performed using a streptavidine-biotin alkaline phosphatase method and ICAM-1 expression was evaluated in a semiquantitative manner. The histologic distribution of the cases was the following: small lymphocytic, five cases; follicular, 14; mantle cell, five; diffuse large cell, 41; and T lymphoblastic, five. Forty patients (57%) were in stage IV, bulky disease was observed in 25 patients (36%), and extranodal involvement in 48 patients (69%).

RESULTS

ICAM-1 expression was negative (-) in 14 patients (20%), weak (+) in 21 (30%), positive (++) in 30 (43%), and strongly positive ( ) in five (7%). No significant relationship was found between ICAM-1 expression and the lymphoma histologic subtype. Patients with negative or weak ICAM-1 expression had more frequently disseminated (stage IV) disease (74% v 40%; P = .007), extranodal involvement (86% v 51%; P = .004), and bone marrow infiltration (57% v 26%; P = .015) than the remainders. Positive ICAM-1 patients had survival rates significantly better than those in whom ICAM-1 was negative or weakly expressed [2-year overall survival: 77% v 50%, respectively; P < .025]. In a multivariate study, ICAM-1 (P = .005) maintained, along with histologic subtype (P = .001) and the international prognostic index (IPI) (P = .056), its importance for predicting survival. Finally, when the group of aggressive non-Hodgkin's lymphoma patients was analyzed, ICAM-1 expression inversely correlated with advanced stage (P = .025), extranodal involvement (P = .01), and bone marrow infiltration (P = .01), complete response (CR) achievement (65% v 32%; P = .025), and overall survival (70% v 26% at 2 years; P < .005).

CONCLUSION

In lymphoma patients, ICAM-1 expression correlates with lymphoma dissemination and is useful to assess prognosis.

摘要

目的

研究细胞间黏附分子-1（ICAM-1）在非霍奇金淋巴瘤中的表达情况，并评估其与疾病分期及预后的相关性。

患者与方法

对来自同一机构的70例非霍奇金淋巴瘤患者（35例男性/35例女性；中位年龄56岁）的ICAM-1（CD54-IOL54）表达进行研究。采用链霉亲和素-生物素碱性磷酸酶法进行免疫染色，并以半定量方式评估ICAM-1表达。病例的组织学分布如下：小淋巴细胞型5例；滤泡型14例；套细胞型5例；弥漫大细胞型41例；T淋巴母细胞型5例。40例患者（57%）处于IV期，25例患者（36%）观察到肿块型病变，48例患者（69%）出现结外受累。

结果

14例患者（20%）的ICAM-1表达为阴性（-），21例（30%）为弱阳性（+），30例（43%）为阳性（++），5例（7%）为强阳性（）。未发现ICAM-1表达与淋巴瘤组织学亚型之间存在显著相关性。ICAM-1表达为阴性或弱阳性的患者比其余患者更常出现疾病播散（IV期）（74%对40%；P = .007）、结外受累（86%对51%；P = .004）和骨髓浸润（57%对26%；P = .015）。ICAM-1阳性的患者生存率显著高于ICAM-1阴性或弱阳性的患者[2年总生存率分别为77%对50%；P < .025]。在多因素研究中，ICAM-1（P = .005）与组织学亚型（P = .001）和国际预后指数（IPI）（P = .056）一样，对预测生存仍具有重要意义。最后，当分析侵袭性非霍奇金淋巴瘤患者组时，ICAM-1表达与晚期（P = .025）、结外受累（P = .01）、骨髓浸润（P = .01）、完全缓解（CR）率（65%对32%；P = .025）及总生存率（2年时70%对26%；P < .005）呈负相关。