The Relationship Between The Clinical Pathological Factors, Immunohistochemical Markers And Prognosis Of Lymphoma

Objective: To analyse the relationship between the clinical pathological factors, immunohistochemical markers and prognosis of lymphoma.Methods: 1, To review 341 patients with lymphoma and record every patients' physical state score, age, gender, pathological type, clinical staging, maximum diameter of tumor, number of tumor site excluding lymphoid nodule, with B symptom or not, LDH level, international prognostic index(IPI), scheme of treatment, time with Interferon therapy, curative effect and time to progression(TTP).2, To determine the expression of Survivin, Bcl-2, Ki-67 and CyclinDl of 110 cases in history by the methods of immunohistochemistry.3,To analyse the relationship between the clinical pathological factors, immunohistochemical marker and TTP of lymphoma by SPSS 12.0.Results: 1, Physical state score, age, clinical staging, maximum diameter of tumor, number of tumor site excluding lymphoid nodule, with B symptom or not, LDH level, curative effect and IPI are prognostic factors that can influence TTP in all 341 cases. And it has linear relativity between these prognostic factors and TTP.2, The rates of the expression of Survivin, Bcl-2, Ki~67 and CyclinDl of 110 cases are 67. 27%, 56. 36%, 35. 45% and 33. 64% respectively.3, Survivin, Bcl-2 and Ki-67 are prognostic factors that can influence TTP in 110 cases. And it has linear relativity between these three markers and TTP.4> The maximum diameter of tumor can influence the expression of Survivin, and it has linear relativity with Survivin;it has statistical significance between age, clinical staging, maximum diameter of tumor, curative effect and the expression of Bcl-2, but only maximum diameter of tumor and curative effect have linear relativities with Bcl-2;the number of tumor site excluding lymphoid nodule, with B symptom or not and LDH level can influence the expression of Ki-67, but they have no linear relativity with Ki-67;LDH level can influence the expression of CyclinDl, but it has no linear relativity with CyclinDl.5* Physical state score, clinical staging, number of tumor site excluding lymphoid nodule, curative effect, Bcl-2 and Ki-67 are six independent prognostic factors that can influence TTP in 110 cases.Conclusions: K The higher the physical state score is, the worse the prognosis is;the older the age is, the worse the prognosis is;the later the clinical staging is, the worse the prognosis is;the larger the maximum diameter of tumor is, the worse the prognosis is;the more the number oftumor site excluding lymphoid nodule is, the worse the prognosis is;the severer the systemic symptom is, the worse the prognosis is;the higher the LDH level is, the worse the prognosis is;the worse the curative effect is, the worse the prognosis is;the higher the IPI is, the worse the prognosis is;the stronger the expression of Survivin or Bcl-2 is, the worse the prognosis is.2^ Maybe Survivin and Bcl-2 can reflect the load of lymphoma of patients, and the larger the load is, the stronger the expression of Survivin or Bcl-2 is. Bcl-2 is the only marker of the four that has relationship with the curative effect. Maybe we can estimate the curative effect of lymphoma with it. Ki-67 and CyclinDl seem to have relationship with the systemic status of patients.3, Physical state score, clinical staging, number of tumor site excluding lymphoid nodule, curative effect, Bcl-2 and Ki-67 are six independent prognostic factors that can influence prognosis of lymphoma. They are very important for patients of lymphoma to estimate the progress of illness and confirm the individual scheme of treatment. Especially, we should treat those patients with strong expression of Bcl-2 and Ki-67 enough.4^ The number of cases in this research is small. The result has only limited referenced value. We should review more cases to validate the conclusions of this research.