【摘要】 背景与目的:根据肿瘤细胞起源不同,可将弥漫大B细胞淋巴瘤(diffuselarge B-cell lymphoma,DLBCL)分为生发中心来源(germinal center B-cell like,GCB)及非生发中心来源(non-GCB)两种亚型。在以CHOP方案为标准的化疗基础上,前者预后优于后者。本研究通过比较R-CHOP(Rituximab联合CHOP)和CHOP方案治疗不同亚型DLBCL患者的近期疗效,寻找初诊DLBCL患者最佳一线治疗方案。方法:将2006年11月至2008年2月中山大学肿瘤防治中心内科收治的83例初治DLBCL患者分为GCB和non-GCB两组。按照修订版淋巴瘤疗效评价标准,比较接受R-CHOP或CHOP方案治疗患者的近期疗效;观察Bcl-2在两种亚型中的表达情况,并分析其与近期疗效的关系。结果:83例DLBCL患者中GCB组35例(42.2%),non-GCB组48例(57.8%)。GCB组一线化疗近期总缓解率74.3%,non-GCB组60.4%,两组相比差异有显著性(P=0.006)。Bcl-2在GCB和non-GCB两亚组的表达差异没有显著性;Bcl-2阳性患者采用R-CHOP方案治疗的近期缓解率(75.6%)明显高于用CHOP方案治疗者(47.8%),两组相比差异有显著性(P=0.031);采用不同方案化疗的Bcl-2阴性患者的近期缓解率则差异无显著性(P>0.05)。结论:GCB组患者接受标准R-CHOP或CHOP方案治疗近期缓解率高于non-GCB组,提示预后良好。加用Rituximab可提高Bcl-2阳性患者的近期缓解率。更多还原

【Abstract】 Background and Objective: Diffuse large B-cell lymphoma (DLBCL) can be divided into two subgroups as germinal center B-cell like (GCB) and non-GCB DLBCL,according to the origin of tumor cells. The prognosis of GCB DLBCL is better than that of non-GCB DLBCL after receiving the CHOP regimen on initial therapy. This study was to compare the short-term efficacy of rituximab (R)-CHOP and CHOP regimens on GCB and non-GCB DLBCL,thus to explore the optimal first-line regimen for the initial treatment of DLBCL patients. Methods: In total eighty-three patients of de novo DLBCL initially treated at Sun Yet-sen University Cancer Center from Nov. 2006 to Feb. 2008 were enrolled. Patients were divided into GCB and non-GCB group. The short-term efficacy of the CHOP or R-CHOP regimen as the first-line therapy on the two groups was evaluated according to the revised response criteria for lymphoma. Bcl-2 expression and its correlation to the short-term efficacy of the two groups were assessed. Results: There were 35 cases (42.2%) in the GCB group and 48 cases (57.8%) in the non-GCB group. The total remission rate was 74.3% in the GCB group and 60.4% in the non-GCB group (P =0.006). There was no significant difference in Bcl-2 expression in the two groups. The remission rate was higher in Bcl-2 positive patients receiving R-CHOP regimen than those receiving CHOP regimen (75.6% vs. 47.8%,P=0.023). There was no significant difference in the remission rate of Bcl-2 negative patients regardless of the regimen. Conclusions: The short-term efficacy is better in the GCB group than in the non-GCB group. Addition of rituximab to CHOP could improve the short-term efficacy of Bcl-2 positive patients.更多还原