| ObjectPrimary testicular lymphoma(PTL)is a disease with testicular mass as the primary symptom or main symptom,not involving other extranodal organs.PTL is the most common testicular tumor type in older men aged over 60 years.The incidence of PTL is increasing in recent years.The prognostic factors of PTL include age,B symptoms,large mass and stages,etc.However,the effective prognostic bio-markers still lack.A total of 38 cases of primary diffuse large B cell lymphoma of testis were selected and diagnosed by friendship hospital of Da Lian medical university and other hospitals in Da Lian during January 2003 to July 2018 as the study object.Then the relationship between clinical factors and prognosis of these patients as well as the prognostic value of immunohistochemical types for primary testicular diffuse large Bcell lymphoma were analyzed expecting to provide an accurate prognostic bio-marker for the primary testicular diffuse large B-cell lymphoma patients.Materials and methods(1)The cases enrolled in this study were patients with primary testicular diffuse large B-cell lymphoma which were admitted and diagnosed by Hospital during January 2003 to July 2018.We conducted a retrospective analysis via collecting the clinical data of 38 patients,including age,stage,affected site,B symptom,chemotherapy,immunohistochemistry,LDH,IPI score and operation modes.(2)The age of 38 patients with primary testicular diffuse large B-celllymphoma was 49-91 years old,including 26 patients aged 65 years or older and 12 patients younger than 65 years old.The left testis was involved in 16 cases,the right testis in 20 cases,and the bilateral testis in 2 cases.All patients were received orchiectomy.Among them 8 patients underwent chemotherapy including CHOP and CVP therapeutic schemes.The other patients hadn't received chemotherapy or other special therapies.According to the standard of Ann Arbor lymphoma stage,there are30 patients in stage I-II and 8 patients in stage III-IV.There were 10 cases with B symptoms and 28 cases without B symptoms.24 cases of GCB and 14 cases of nonGCB were identified by immunohistochemistry.There were 34 patients with normal LDH and 4 patients with abnormal LDH.30 patients with IPI score of 0-2 and 8patients with IPI score of 3-5.(3)Immunohistochemistry was used to detect the positive expression rates of CD20,CD10,Bcl-6 and MUM-1 antigens.(4)Kaplan Meier analysis was used to analyze the overall survival of patients with primary testicular diffuse large B-cell lymphoma,and single factor and multi factor Cox regression model analyses were utilized to evaluate the impacts of different clinical data on the prognosis of patients.The data were analyzed by SPSS25.0 and Graphpad prism 5.Results(1)According to Kaplan Meier analysis,the median OS time of 38 patients was 39.0 months,the 1-year survival rate was 82.5%,the 3-year survival rate was54.3%,and the 5-year survival rate was 23.7%.(2)According to survival analysis,the effects of different clinical data on OS and progression-free survival were different.According to survival analysis,different clinical data have different effects on OS and PFS.Stage,IPI score and immunohistochemistry classification of patients with primary testicular diffuse largeB cell lymphoma have significant effects on OS and PFS.(3)The positive expression rate of CD20 antigen,CD10,bcl-6 and MUM-1were severally 99%,53%,68% and 99% in tumor cells according to immunohistochemistry.(4)In single factor Cox regression analysis,stage ?/?,B-symptom,nonGCB type,non chemotherapy and high IPI score(3 ? 5)were all poor prognostic factors of primary testicular diffuse large B-cell lymphoma.(5)Through multivariate Cox regression analysis,we found that the non-GCB type and B symptoms could be used as an independent prognostic factor for patients with primary testicular diffuse large B-cell lymphoma.Conclusion(1)The stage,IPI score and immunohistochemical typing of patients with primary diffuse large B cell lymphoma of testis had significant effects on OS and PFS.(2)Stage,B-symptom,immunohistochemistry,chemotherapy and IPI were all related to the prognosis of patients with primary testicular diffuse large B-cell lymphoma.(3)B symptoms and immunohistochemical typing are independent prognostic factors of primary testicular diffuse large B cell lymphoma.(4)Immunohistochemical typing may participate in the tumor progression of diffuse large B Cell lymphoma and provide a effective method for the prediction of the prognosis. |
PDF Full Text Request