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血管生成素1、2在弥漫大B细胞淋巴瘤中的表达及预后价值

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目的 探讨血管生成素1、2(Ang1、Ang2)在弥漫大B细胞淋巴瘤(DLBCL)中的表达及其生存预后分析。方法 收集32例初诊DLBCL患者及30名健康体检者(健康对照组)外周血,ELISA检测血清Ang1、Ang2水平。取DLBCL患者活检组织及25例非肿瘤病变患者颈部手术切除的正常淋巴结活检组织(对照组)标本,免疫组化检测CD34的表达并计算微血管密度;结合DLBCL患者临床特征、随访资料进行统计分析。结果 DLBCL 患者血清 Ang1 水平高于健康对照组[(36。22±9。12)ng/mL vs。(30。92±13。37)ng/mL],DL-BCL 患者血清Ang2水平高于健康对照组[(28。42±10。78)ng/mL vs。(23。81±3。68)ng/mL],且差异有统计学意义(均P<0。05)。DLBCL患者淋巴瘤组织CD34高表达,而正常淋巴结组织CD34低表达;DLBCL患者淋巴瘤组织微血管密度计数较正常淋巴结组织增多(25。5±4。4 vs。13。2±3。0,P<0。05)。Ang1水平与性别、年龄、国际预后指数(IP1)评分、临床分期、细胞起源(COO)亚型均无明显相关性。Ang2水平与Ann Arbor分期有关,Ⅰ~Ⅱ期DLBCL患者Ang2低表达,而Ⅲ~Ⅳ期患者Ang2高表达(P<0。05);Ang2水平与性别、年龄、IPI评分、COO亚型均无明显相关性。Ang1低表达患者OS时间与Ang1高表达患者无明显差异(25。86个月vs。23。11个月,P=0。722);Ang2低表达患者OS时间明显高于Ang2高表达患者(32。24个月vs。17。66个月,P=0。002)。单因素分析显示Ann Arbor分期、IPI评分、Ang2水平均为影响患者OS时间的因素;而性别、年龄、Ang1水平与患者OS时间无明显相关性。多因素分析显示Ann Arbor分期、IPI评分、Ang2水平均为影响患者OS时间的独立预后因素。结论 Ang1、Ang2在DLBCL患者高表达,促进淋巴瘤血管新生;Ang2水平影响DLBCL患者生存预后。
Expression and prognostic value of angiopoietin 1 and angiopoietin 2 in diffuse large B-cell lymphoma
Objective To investigate the expression of angiopoietin 1 and 2(Ang1,Ang2)in diffuse large B-cell lymphoma(DLBCL)and its survival prognosis analysis.Methods Peripheral blood was collected from 32 patients with initially diagnosed DLBCL and 30 healthy volunteers(the health control group),and the serum Ang1 and Ang2 levels were detected by ELISA.The biopsy tissues from DLBCL patients and the resec-ted normal lymph node biopsy tissues in neck surgery of 25 patients with non-tumor lesions(the control group)were taken as the specimens.The immunohistochemistry was used to detect the expression of CD34 in lymphoid tissues and the microvessel density was calculated;the statistical analyses were carried out by combi-ning with the clinical characteristics of the DLBCL patients and the follow-up data.Results The serum Ang1 level in initially diagnosed DLBCL was higher than that in the healthy control group[(36.22±9.12)ng/mL vs.(30.92±13.37)ng/mL],and the serum Ang2 level in initially diagnosed DLBCL was higher than that in the healthy control group[(28.42±10.78)ng/mL vs.(23.81±3.68))ng/mL],and the differences were sta-tistically significant(P<0.05).CD34 was highly expressed in the lymphoma tissues of the patients with DL-BCL,whereas CD34 in normal lymph node tissues was weakly expressed;the microvessel density count in the DLBCL group was increased compared with the normal lymph node group(25.5±4.4 vs.13.2±3.0,P<0.05).The Ang1 expression level had no significant correlation with the gender,age,IPI score,clinical stage and COO subtype.The Ang2 expression was correlated with the clinical stage,Ang2 was lowly expressed in the patients with stage Ⅰ-Ⅱ DLBCL,while which was highly expressed in the patients with stage Ⅲ-Ⅳ(P<0.05);Ang2 had no significant correlation with the gender,age,IPI score and COO subtype.The OS time had no significant difference between the patients with Ang1 low expression and the patients with Ang1 high expression(25.86 months vs.23.11 months,P=0.722);the OS time in the patients with Ang2 low ex-pression was significantly higher than in the patients with high Ang2 expression(32.24 months vs.17.66 months,P=0.002).In the univariate analysis,Ann Arbor stage,IPI score and Ang2 all were the prognostic factors affecting the patients'OS,while gender,age and Ang1 had no significant correlation with the patients'OS.In Cox multifactorial analysis,the Ann Arbor stage,IPI score and Ang2 all were the independent prog-nostic factors affecting the patients'OS.prognostic factors.Conclusion Ang1 and Ang2 are highly expressed in DLBCL patients and promote lymphoma angiogenesis;Ang2 affects the survival prognosis of DLBCL patients.

angiopoietindiffuse large B-cell lymphomaprognosis

李天寿、梁远初、王健琨、黄云、刘琴、韦敏、黄锦雄

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柳州市人民医院血液内科,广西柳州 545006

柳州市人民医院病理科,广西柳州 545006

血管生成素 弥漫大B细胞淋巴瘤 预后

2024

重庆医学
重庆市卫生信息中心,重庆市医学会

重庆医学

CSTPCD
影响因子:1.797
ISSN:1671-8348
年,卷(期):2024.53(17)