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目的:探讨外周T细胞淋巴瘤-非特指型(PTCL-U)的临床病理预后模型。方法:应用免疫组化的方法检测2005-05/2008-05 55例经病理确诊的PTCL-U患者的病理组织的NF-κB/p50、P-gp170、GST-π、TOPO、Ki-67的表达情况,结合国际预后指数(IPI)分析临床病理预后因子与治疗效果、预后的关系。结果:本组55例患者中NF-κB/p50、P-gp170糖蛋白、GST-π、TOPO的表达阳性率分别为21.8%(12/55)、60.0%(33/55)、50.9%(28/55)和54.5%(30/55)。Ki-67的表达阳性率在5%~90%之间,中位的百分率为65%。NF-κB/p50阳性组,耐药阳性组,Ki-67高表达(≥65%)组与对照组相比较首程治疗完全缓解率无显著差异。本文提出了将NF-κB/p50阳性、MDR阳性(本文定义)和Ki-67高表达分别赋值1分,结合IPI5分的共计8分的临床病理预后模型(CPPI)。≥4分为高危组,<4分为低危组,根据CPPI评分的低、高危组间首程治疗完全缓解率、总的生存率间的差异显著(P=0.014 6;P=0.000 0)。多因素生存分析显示,CPPI评分(P=0.034)是PTCL-U的独立预后因素。结论:临床病理预后模型(CPPI)能够在一定程度上预测PTCL-U对化疗的反应性和预后。
Objective: To investigate the clinical and pathological prognosis of peripheral T-cell lymphoma - nonspecific (PTCL-U). Methods: Immunohistochemistry was used to detect the expressions of NF-κB / p50, P-gp170, GST-π, TOPO and Ki-67 in 55 pathologically confirmed PTCL-U patients from 2005-05 / 2008-05 Expression, combined with international prognostic index (IPI) analysis of clinical pathological prognostic factors and treatment effect, prognosis. Results: The positive rates of NF-κB / p50, P-gp170 glycoprotein, GST-π and TOPO in 55 patients were 21.8% (12/55), 60.0% (33/55) and 50.9% 28/55) and 54.5% (30/55). The positive rate of Ki-67 expression was between 5% and 90%, the median percentage was 65%. There was no significant difference in complete remission rate of first-line treatment between NF-κB / p50 positive group, drug-resistant positive group and Ki-67 high expression group (≥65%) compared with control group. In this paper, a total of 8 points of clinical pathological prognostic models (CPPI) that assign a score of 1 for NF-κB / p50-positive, MDR-positive (defined herein) and Ki-67- ≥4 were divided into high-risk group, <4 were divided into low-risk group, according to the CPPI score low and high-risk group first-line treatment of complete remission rate, the overall survival rate was significantly different (P = 0.014 6; P = 0.000 0) . Multivariate survival analysis showed that the CPPI score (P = 0.034) was an independent prognostic factor for PTCL-U. Conclusion: The clinical pathological prognosis model (CPPI) can predict the reactivity and prognosis of PTCL-U to chemotherapy to a certain extent.