A Study On The Prognostic Factors Of Diffuse Large B Cell Lymphoma

Objective:To analyse the relationship between the clinical pathological factors(such as age,gender,clinical staging, tumor site excluding lymphoid nodule or not, with B symptom or not , physical state score,LDH level, international prognostic index,curative effect et),Bcl-2 and Ki-67 protein expression and prognosis of Diffuse large B cell lymphoma (DLBCL).Materials and methods:1.Forty-one cases of DLBCL treated between 2002 and 2008 entered this study. Record every patient's age,gender,clinical staging, tumor site excluding lymphoid nodule or not, with B symptom or not , physical state score,LDH level, international prognostic index(IPI),curative effect and overall surviva(OS).2.To detect the expression of Bcl-2and Ki-67 of the Forty-one cases by the methods of immunohistochemistry.3. To analyse the final data by SPSS16.0 sofeware. Analyse the expression of Bcl-2 and Ki-67,the relationship between the clinical pathological factors and the expression of Bcl-2and Ki-67,the relationship between the clinical pathological factors,immunohistochemical marker and overall surviva(OS).Results:1.The positive expression rate of Bcl-2and Ki-67 in RH was 25.00% and 30.00%respectively, while in DLBCL was 63.41% and 68.29% respectively. There was significant difference in the expression rates between DLBCL and RH.2. Bcl-2 protein and Ki-67 protein were positively coexpressed in 15 cases DLBCL, negatively coexpressed in 2 cases DLBCL. There was a negative correlation between the expression of Bcl-2 protein and Ki-67 protein in DLBCL.3.There were no correlation between the expression of Bcl-2 protein with age,sex,LDH lever, physical state score, B symptoms and extra-nodal extension. There were no correlation between the expression of Ki-67 and age,sex, Ann Arbor stage, physical state score, B symptoms,extra-nodal extension,and IPI score. But there were positive correlation between the expression of Bcl-2 protein and Ann Arbor stage, IPI score.And there were positive correlation between the expression of Ki-67 protein and LDH lever.4. There were no correlation between the curative effect and sex,LDH lever, physical state score, B symptoms and extra-nodal extension, the expression of Ki-67. But there were positive correlation between the curative effect and age, Ann Arbor stage, IPI score, the expression of Bcl-2 protein.5.Simple analysis showed that age, Ann Arbor stage, LDH lever, IPI score, the expression of Bcl-2 and Ki-67 protein, the curative effect were prognostic factors of DLBCL. Multivariate analysis showed that Ann Arbor stage, IPI score, the expression of Bcl-2 and Ki-67 protein, the curative effect were independent prognostic factors of DLBCL.Conclusion:1.There were significant differences in the expression of Bcl-2 and Ki-67 protein between DLBCL and RH,so to detect the expression of them has clinical value to discriminate the two diseases.2.There was a negative correlation between the expression of Bcl-2 and Ki-67 protein, which indicates that they may not play a synergistic role in the occurrence and development of DLBCL.3.There were significant difference between the positive expression of Bcl-2 and clinic stage, between the positive expression of Bcl-2 and IPI score. Which demonstrates that there was a correlation between Bcl-2 protein expression and stages of DLBCL. To detect the expression of it could predict the prognosis for the patients with DLBCL and guide clinical therapy.4. There was a significant difference between the positive expression of Ki-67 and LDH lever. Which demonstrates that Ki-67 was a good index of tumour cell proliferation and aggressive degree. To detect the expression of it could predict the prognosis for the patients with DLBCL and guide clinical therapy. 5.Older than 60, Stageâ…¢+â…£, IPI score >2 and the positive expression of Bcl-2 signify a bad curative effect.6. Multivariate analysis showed that Ann Arbor stage, IPI score, the expression of Bcl-2 and Ki-67 protein, the curative effect were independent prognostic factors of DLBCL. Which could predict the progression of disease for the patients with DLBCL and guide clinical therapy.