摘要目的 观察CD5在弥漫性大B细胞淋巴瘤(DLBCL)中的表达,并探讨其与各种临床病理因素间的关系.方法 回顾性分析2001年1月至2010年12月吉林大学白求恩第一医院诊断明确、病例资料齐全的DLBCL患者的石蜡标本共160例,应用免疫组织化学(SP法)染色检测肿瘤组织中CD5、CD10、bcl-6和MUM-1蛋白表达情况.应用x2检验比较CD5表达与不同临床特征及病理亚型的关系,单因素生存分析采用Kaplan-Meier分析和Log-rank检验.结果 年龄≥60岁DLBCLCD5+患者发病比例(12/17)显著高于CD5-患者(39.9％,57/143),CD5+患者2个或更多结外受累比例(11/17)显著高于CD5-患者(31.5％,45/143),CD5+患者因DLBCL导致死亡的比例(13/17)显著高于CD5-患者(37.1％,53/143).生存分析显示,CD5+患者的总生存期和无事件生存期(EFS)均显著低于CD5-患者.依据国际预后指数(IPI)、生发中心B细胞(GCB)分型和治疗方案分层分析显示,在不同的GCB分型、不同的治疗方案及IPI(0 ～2)的情况下,CD5+ DLBCL患者的总生存期均显著低于CD5- DLBCL患者,而当IPI(3 ～5)时,CD5+和CD5- DLBCL患者的总生存期差异无统计学意义(P＞0.05).结论 CD5表达是DLBCL的不良预后因素,当IPI指数低(0～2)时,CD5的表达对预后更有预测意义.

abstractsObjective To analyze CD5 expression in diffuse large B cell lymphoma (DLBCL) and to explore its relationship with the clinicopathological characteristics.Methods The clinical data from 160 DLBCL patients who were treated in First Bethune Hospital of Jilin University from January 2001 to December 2010 were retrospectively analyzed.Immunohistochemical staining (SP method ) for CD5,CD10,bcl-6 and MUM-1 was performed on the paraffin-embedded tissue.The relationship between CD5 expression and the clinicopathological characteristics was evaluated by Chi-square test. Survival analysis adopted Kaplan-Meier analysis and Log-rank test.Results In the patients aged 60 years or older,the incidence of CD5 + lymphoma (12/17) was significantly higher than that of CD5 - ones (39.9％,57/143) ; two or more extranodal involvements in CD5+ patients (11/17) were more commonly found than that of CD5- patients (31.5％,45/143); DLBCL-related death in CD5 + patients (13/17) was higher than that of CD5- patients (37.1％,53/143).Survival analysis showed that the overall survival (OS) and the event-free survival (EFS) of CD5 + patients were significantly lower than those of CD5 - patients.In the condition of different GCB type,different therapy and low IPI (0 ～2),the OS of CID5 + DLBCL patients was significantly lower than that of CD5 - patients,while in the condition of high IPI (3 ～ 5),the OS of CD5 + and C1D5 - DLBCL patient had no obvious difference.Conclusions CD5 expression is an adverse prognostic factor in DLBCL and it has more prognostic value in the condition of low IPI (0 ～2).