淋巴结滤泡辅助T细胞淋巴瘤-血管免疫母细胞型临床病理特征和预后因素分析

贺娟, 王星宇, 何鸿, 王立鑫, 谭艳梅, 李源鑫, 黄颖, 余快, 赵敏, 谢涛, 李丹

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重庆医科大学学报 ›› 2024, Vol. 49 ›› Issue (07) : 895-903. DOI: 10.13406/j.cnki.cyxb.003547
临床研究

淋巴结滤泡辅助T细胞淋巴瘤-血管免疫母细胞型临床病理特征和预后因素分析

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Clinicopathological features and prognostic factors of nodal T-follicular helper cell lymphoma,angioimmunoblastic-type

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摘要

目的 探讨淋巴结滤泡辅助T细胞淋巴瘤-血管免疫母细胞型(nodal T-follicular helper cell lymphoma,angioimmuno-blastic-type,nTFHL-AI)临床病理特征和预后因素。 方法 回顾性分析63例nTFHL-AI患者临床信息,利用免疫组化(immunohistochemistry,IHC)、原位杂交(in situ hybridization,ISH)和抗原受体基因重排评估nTFHL-AI临床病理特征。使用Cox比例风险回归模型评估预后因素。 结果 免疫染色提示CD4阳性肿瘤细胞例数明显超过CD8(66% vs. 5%)。Epstein-Barr病毒(Epstein-Barr virus,EBV)编码的小RNA(EBV-encoded small RNA,EBER)阳性患者比EBER阴性患者更易表达CXCL13(P=0.006)。5年总体生存期(overall survival,OS)和无进展生存期(progression-free survival,PFS)分别为31%和16%。CXCL13阳性组OS和PFS显著优于CXCL13阴性组(P=0.003、P=0.040)。相反,BCL6阳性表达与较差的OS和PFS相关(P=0.026、P= 0.044),EBER阴性也与较差的OS和PFS相关(P=0.013、P=0.047)。多因素分析表明EBER阴性是OS和PFS独立不良预后因素(P=0.001、P=0.003)。 结论 CXCL13阳性预示nTFHL-AI患者预后良好,而BCL6阳性和EBER阴性与患者预后不良相关,并且EBER阴性是患者预后的独立危险因素。

Abstract

Objective To investigate the clinicopathologic features and prognostic factors of nodal T-follicular helper cell lymphoma,angioimmunoblastic-type(nTFHL-AI). Methods A retrospective analysis was performed for the clinical information of 63 patients with nTFHL-AI,and immunohistochemistry,in situ hybridization,and antigen receptor gene rearrangement were used to assess the clinicopathological features of nTFHL-AI. The Cox proportional hazards regression model was used to investigate prognostic factors. Results Immunostaining showed that the number of patients with dominant CD4-positive cells was significantly higher than that of patients with dominant CD8-positive cells(66% vs. 5%). The patients who tested positive for Epstein-Barr virus-encoded small RNA (EBER) showed a higher probability for the expression of CXCL13 compared with their EBER-negative counterparts(P=0.006). The 5-year overall survival(OS) rate and the progression-free survival(PFS) rate were 31% and 16%,respectively. The CXCL13-positive group had significantly better OS and PFS than the CXCL13-negative group(P=0.003 and 0.040). On the contrary,positive BCL6 expression was associated with worse OS and PFS(P=0.026 and 0.044),and negative EBER was also associated with worse OS and PFS(P=0.013 and 0.047). The multivariate analysis showed that negative EBER was an independent negative prognostic factor for both OS and PFS(P=0.001 and 0.003). Conclusion Positive expression of CXCL13 indicates a favorable prognosis of nTFHL-AI patients,while positive BCL6 and negative EBER are associated with poor prognosis,and negative EBER is an independent risk factor for the prognosis of patients.

关键词

淋巴结滤泡辅助T细胞淋巴瘤-血管免疫母细胞型 / 滤泡辅助T细胞表型 / Epstein-Barr病毒编码的小RNA / 预后

Key words

nodal T-follicular helper cell lymphoma,angioimmunoblastic-type / T-follicular helper cell phenotype / Epstein-Barr virus-encoded small RNA / prognosis

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R363

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贺娟 , 王星宇 , 何鸿 , . 淋巴结滤泡辅助T细胞淋巴瘤-血管免疫母细胞型临床病理特征和预后因素分析. 重庆医科大学学报. 2024, 49(07): 895-903 https://doi.org/10.13406/j.cnki.cyxb.003547
He Juan, Wang Xingyu, He Hong, et al. Clinicopathological features and prognostic factors of nodal T-follicular helper cell lymphoma,angioimmunoblastic-type[J]. Journal of Chongqing Medical University. 2024, 49(07): 895-903 https://doi.org/10.13406/j.cnki.cyxb.003547

参考文献

1
Lunning MA Vose JM. Angioimmunoblastic T-cell lymphoma:the many-faced lymphoma[J]. Blood2017129(9):1095-1102.
2
Vose J Armitage J Weisenburger D,et al. International peripheral T-cell and natural killer/T-cell lymphoma study:pathology findings and clinical outcomes[J]. J Clin Oncol200826(25):4124-4130.
3
Alaggio R Amador C Anagnostopoulos I,et al. The 5th edition of the World Health Organization classification of haematolymphoid tumours:lymphoid neoplasms[J]. Leukemia202236(7):1720-1748.
4
Chiba S Sakata-Yanagimoto M. Advances in understanding of angioimmunoblastic T-cell lymphoma[J]. Leukemia202034(10):2592-2606.
5
Lachenal F Berger F Ghesquières H,et al. Angioimmunoblastic T-cell lymphoma[J]. Medicine200786(5):282-292.
6
Mourad N Mounier N Brière J,et al. Clinical,biologic,and pathologic features in 157 patients with angioimmunoblastic T-cell lymphoma treated within the Groupe d’Etude des Lymphomes de l’Adulte (GELA) trials[J]. Blood2008111(9):4463-4470.
7
Dunleavy K Wilson WH Jaffe ES. Angioimmunoblastic T cell lymphoma:pathobiological insights and clinical implications[J]. Curr Opin Hematol200714(4):348-353.
8
Xie Y Jaffe ES. How I diagnose angioimmunoblastic T-cell lymphoma[J]. Am J Clin Pathol2021156(1):1-14.
9
He XY Xu P Wang XW,et al. The association of gene rearrangement and lymphoma diagnosis:a prospective observational study[J]. Medicine202099(24):e20733.
10
Cheson BD Fisher RI Barrington SF,et al. Recommendations for initial evaluation,staging,and response assessment of Hodgkin and non-Hodgkin lymphoma:the Lugano classification[J]. J Clin Oncol201432(27):3059-3068.
11
Eladl AE Shimada K Suzuki Y,et al. EBV status has prognostic implication among young patients with angioimmunoblastic T-cell lymphoma[J]. Cancer Med20209(2):678-688.
12
Basha BM Bryant SC Rech KL,et al. Application of a 5 marker panel to the routine diagnosis of peripheral T-cell lymphoma with T-follicular helper phenotype[J]. Am J Surg Pathol201943(9):1282-1290.
13
Bahri R Boyer F Halabi MA,et al. Epstein-barr virus(EBV) is mostly latent and clonal in angioimmunoblastic T cell lymphoma(AITL)[J]. Cancers202214(12):2899.
14
Dobay MP Lemonnier F Missiaglia E,et al. Integrative clinicopathological and molecular analyses of angioimmunoblastic T-cell lymphoma and other nodal lymphomas of follicular helper T-cell origin[J]. Haematologica2017102(4):e148-e151.
15
Chen HZ Tao YX Zhou Y,et al. The clinical features,treatment,and prognostic factors for peripheral T-cell lymphomas:a single-institution analysis of 240 Chinese patients[J]. Asia Pac J Clin Oncol202319(5):e202-e214.
16
de Leval L Parrens M Le Bras F,et al. Angioimmunoblastic T-cell lymphoma is the most common T-cell lymphoma in two distinct French information data sets[J]. Haematologica2015100(9):e361-e364.
17
Wei C Li W Qin LP,et al. Clinicopathologic characteristics,outcomes,and prognostic factors of angioimmunoblastic T-cell lymphoma in China[J]. Cancer Med202312(4):3987-3998.
18
Advani RH Skrypets T Civallero M,et al. Outcomes and prognostic factors in angioimmunoblastic T-cell lymphoma:final report from the international T-cell Project[J]. Blood2021138(3):213-220.
19
Cortés JR Palomero T. The curious origins of angioimmunoblastic T-cell lymphoma[J]. Curr Opin Hematol201623(4):434-443.
20
Lage LAPC Culler HF Reichert CO,et al. Angioimmunoblastic T-cell lymphoma and correlated neoplasms with T-cell follicular helper phenotype:from molecular mechanisms to therapeutic advances[J]. Front Oncol202313:1177590.
21
Joshi K Liu SH Peter Breslin SJ,et al. Mechanisms that regulate the activities of TET proteins[J]. Cell Mol Life Sci202279(7):363.
22
Nishizawa S Sakata-Yanagimoto M Hattori K,et al. BCL6 locus is hypermethylated in angioimmunoblastic T-cell lymphoma[J]. Int J Hematol2017105(4):465-469.
23
Crichton ES Zeng S La Muraglia GM 2nd,et al. CXCL13 is an indicator of germinal center activity and alloantibody formation following transplantation[J]. Transplant Direct20217(12):e785.
24
Kim TY Min GJ Jeon YW,et al. Impact of epstein-barr virus on peripheral T-cell lymphoma not otherwise specified and angioimmunoblastic T-cell lymphoma[J]. Front Oncol202111:797028.
25
Liang JH Lu L Zhu HY,et al. The prognostic role of circulating epstein-barr virus DNA copy number in angioimmunoblastic T-cell lymphoma treated with dose-adjusted EPOCH[J]. Cancer Res Treat201951(1):150-157.
26
Dunleavy K Wilson WH. Angioimmunoblastic T-cell lymphoma:immune modulation as a therapeutic strategy[J]. Leuk Lymphoma200748(3):449-451.

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重庆医科大学重点资助项目(ZHYX202104)

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