| ObjectivePeripheral T-cell lymphoma, not otherwise specified(PTCL-NOS) is the major common subtype of Peripheral T-cell lymphoma. PTCL-NOS is very common in our country,but the condition is contrary in western countries.PTCL-NOS has the characteristics of high malignant degree and prognosis, there is no standard first-line therapy, and prognostic indicators also refer to the IPI diffuse large B cell lymphoma. Compared with diffuse large B cell lymphoma, PTCL NOS have many different biological characteristics, thus to explore beyond the IPI is more suitable for the prognosis of PTCL-NOS predictor undoubtedly has important clinical significance.lt is necessary to find certain molecular markers to identify poor-risk patients more correctly. Thus, there is still significant opportunity for improving survival in PTCL-NOS patients.MethodsFrom2002.1-2008.1, we collected the clinical data characteristics of60PTCL-NOS patients in Tianjin Medical University Cancer Hospital. The clinical data including age, gender, ECOG performance status, Ann Arbor stage, IPI, bone marrow involvement, B symptom, Extranodal involvement, LDH level, therapy model, histology type, they were analyzed retrospectively. Clinical evaluation was done according to the standard. Followed-up to2011.1by telephones and letters. Immunohistochemistry was used to detect the expression of CD68and VEGF in the tumor specimens of60cases with PTCL-NOS, and normal lymph node biopsies were used as controls..A statistical analysis is carried out of the association of TAM, VEGF and the clinico-pathological characteristics.OS rates were calculated according to the Kaplan-Meier method and differences between survival curves were evaluated using the log-rank test.The Cox proportional hazard regression model was used for univariate analyses. Multivariate analysis was performed using Cox regression model. The correlation ofTAM and VEGF with IPI score, Ann-Arbor stage was used by Pearson correlation analysis. Statistical analyses were performed with SPSS16.0software.P<0.05was considered statistically significant. ResultThe CD68positive cell content was56.5±18.6/high-power field (hpf) in PTCL-NOS tissues, and12.4±6.2/hpf in controls(P<0.01). The VEGF-positive rate was78.3%and26.7%(P<0.05),respectively. TAMs were significantly related to bone marrow invasion, IPI score, and response to treatment (P<0.05). The2-year overall survival (OS) of the high-TAMs-expression and low-TAMs-expression group was23.6%and55.3%(P<0.05). The expression of VEGF was closely related to tumor staging, bone marrow invasion, and IPI score P<0.05). The2-year OS of the VEGF-positive group and VEGF-negative group was22.9%and83.3%(P<0.01). Univariate survival analysis revealed that VEGF expression, TAMs content, tumor staging, IPI score, and response to treatment were the predictive factors of prognosis for patients with PTCL-NOS (P<0.05). A multivariate Cox regression model showed that VEGF and response to treatment were both independent predictors of OS (P <0.05).ConclusionBesides IPI、LDH、tumor stage and effects were PTCL-NOS’s prognosis factors,it’s proved that TAMs and VEGF are overexpressed in PTCL-NOS. Univariate survival analysis revealed that TAMs and VEGF are both predictive factors for PTCL-NOS prognosis, Cox regression analysis of multivariate survival data shows that only VEGF is an independent predictive factor for OS.TAM,VEGF expression can be used to assess tumor proliferation and may be useful as an additional marker when combined with traditional marker to refine the prediction of outcome in PTCL-NOS.Besides,TAM、VEGF signal pathway maybe the therapeutic target of new drug for PTCL-NOS lymphoma. |
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