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目的:滤泡性淋巴瘤(FL)是最常见的惰性NHL,亦是一种异质性的疾病。FL的预后指标是临床上广泛应用的滤泡淋巴瘤国际预后指标(FLIPI),具有较高的准确性和简便性,但相同FLIPI的患者预后情况实际不尽相同,反映了FL异质性的特点,在相同的组织分类中存在遗传学和生物学特征不同的亚型。因此有必要寻找新的分子指标以期更准确地预测FL患者的预后。本研究旨在探讨淋巴瘤相关巨噬细胞(LAM)对FL预后判断的价值。方法:免疫组化二步法检测2002年2月至2006年11月间收治的48例初治FL患者组织中LAM的密度,分析其表达与患者临床特征、近期疗效及远期生存率的关系。结果:48例FL患者LAM低密度者38例(79.2%),高密度者10例(20.8%)。LAM密度与患者年龄、PS状态、血清LDH水平、分期等临床特征无关,与FLIPI评分也无相关性。LAM低密度组化疗疗效和高密度组相近。全组48例患者未达到中位生存期(MST),LAM低密度组MST优于高密度组(P=0.002)。多因素分析结果显示LAM与FL的预后无明显相关(P>0.05)。结论:LAM的高密度与FL的远期生存呈负相关。但由于本研究入组患者较少,随访时间短,未能达到统计学意义,值得进一步探讨。
Purpose: Follicular lymphoma (FL) is the most common form of inert NHL and is also a heterogeneous disease. The prognostic indicators of FL are widely used international clinical indicators of follicular lymphoma (FLIPI), with high accuracy and simplicity, but the same prognosis of patients with FLIPI actually vary, reflecting the heterogeneity of FL It is characterized by subtypes of different genetic and biological characteristics in the same tissue classification. Therefore, it is necessary to find new molecular indicators in order to more accurately predict the prognosis of FL patients. The purpose of this study was to investigate the value of lymphoma associated macrophages (LAMs) in the prognosis of FL. Methods: The density of LAM in 48 patients with newly diagnosed FL patients admitted from February 2002 to November 2006 was detected by two-step immunohistochemistry. The relationship between the expression of LAM and the clinical features, short-term efficacy and long-term survival was analyzed . Results: In 48 patients with FL, 38 cases (79.2%) had low density of LAM and 10 cases (20.8%) had high density. LAM density had no correlation with clinical features such as patient’s age, PS status, serum LDH level and staging, and had no correlation with FLIPI score. LAM low-density chemotherapy and high-density group similar. The median survival time (MST) was not achieved in 48 patients in the whole group, but MST in LAM low density group was superior to high density group (P = 0.002). Multivariate analysis showed no significant correlation between LAM and the prognosis of FL (P> 0.05). Conclusion: The high density of LAM is negatively correlated with the long-term survival of FL. However, due to the small number of patients enrolled in this study, follow-up time is short, failed to reach statistical significance, it is worth further study.