Objective: To investigate the expression and clinical significance of CD30 in patients with diffuse large B-cell lymphoma (DLBCL).
Methods: A retrospective analysis was conducted on 124 cases of primary DLBCL diagnosed at Changzhou Second People's Hospital Affiliated with Nanjing Medical University from January 2018 to July 2020. The expression of CD30 in patients with DLBCL was detected by immunohistochemical method, and the clinicopathological characteristics were analyzed and compared between CD30+ and CD30- groups. Kaplan-Meier analysis was used for survival analysis. The relationship between CD30 expression and clinical features and prognosis were analyzed.
Results: Among the 124 patients with DLBCL, 19 patients expressed CD30, and the positive rate is 15.32%. The clinico-pathological characteristics of CD30+ in patients with DLBCL were characterized by low age, more common in males, fewer extranodal lesions, lower international prognostic index (IPI), GCB type being more common in Hans subtype, and achieving better therapeutic effects (P < 0.05). However, there were no significant statistical differences in B-symptoms (P =0.323), Ann Arbor staging (P =0.197), Eastern Cooperative Oncology Group (ECOG) score (P =0.479), lactate dehydrogenase (LDH) (P =0.477), and the involvement of bone marrow (P =0.222). There were significant differences in OS and PFS between the CD30+ and CD30- groups (χ2=5.653, P =0.017; χ2＝4.109，P =0.043), the CD30+ group had a better prognosis than that of the CD30- group. The results of subgroup analysis showed that the CD30+ group in the IPI score=1-2, LDH elevated group had a better prognosis (P < 0.05). In the subgroups of Ann Arbor staging III-IV (P =0.055) and non GCB type (P =0.053), the CD30+ group had a good prognosis trend, but the difference was not statistically significant. The results of univariate analysis showed that the good prognosis of DLBCL patients was closely related to CD30+ expression, no B-symptoms, early Ann Arbor staging, low ECOG score, normal LDH, low IPI score, fewer extranodal involvement, and obtaining the best therapeutic effect as CR (all P <0.05). COX multivariate regression analysis showed that the presence of B-symptoms and achieving the best therapeutic effect as Non-CR were independent risk factors affecting the prognosis of DLBCL patients (P < 0.05).
Conclusion: The CD30+ expression in DLBCL patients indicates a good prognosis and has certain diagnostic value in evaluating the prognosis of DLBCL patients.
题目: CD30在弥漫性大B细胞淋巴瘤患者中的表达及其临床意义.
目的: 探讨CD30在弥漫性大B细胞淋巴瘤（DLBCL）患者中的表达及其临床意义。.
方法: 回顾性分析2018年1月至2020年7月在南京医科大学附属常州第二人民医院诊断的124例原发性DLBCL患者，采用免疫组织化学染色法检测CD30在DLBCL中 的表达情况，分析比较CD30表达阳性组与阴性组间各临床病理特征，应用Kaplan-Meier法进行生存分析。分析CD30表达与各临床特征及预后的关系。.
结果: 124例DLBCL中，CD30+ 19例（15.32%）。CD30+ DLBCL患者的临床病理特征具有年龄低、男性多见、结外受累数目少、国际预后指数（IPI）小、Hans分型以GCB型多见、获得的最佳疗效较好的特点（P < 0.05）。但在有无B组症状（P ＝0.323）、Ann Arbor分期（P ＝0.197）、美国东部肿瘤协作组（ECOG）评分（P ＝0.479）、乳酸脱氢酶（LDH）值（P ＝0.477）及是否累及骨髓（P ＝0.222）方面无明显统计学差异。CD30+ 与CD30- 组的OS、PFS均具有显著性差异（χ2=5.653, P =0.017；χ2＝4.109，P =0.043），阳性组预后较阴性组好。亚组分析结果显示，在IPI评分1-2分、LDH升高组中CD30+组有较好的预后（P <0.05）；在Ann Arbor分期为Ⅲ-Ⅳ期（P =0.055）、Hans分型为non-GCB型（P =0.053）亚组中CD30+组有较好的预后趋势,但差异未显示出统计学意义。单因素分析结果显示，DLBCL患者的良好预后与CD30+表达、无B组症状、Ann Arbor分期早、ECOG评分低、LDH值正常、IPI评分低、结外受累数目少、获得最佳疗效为CR密切相关（均P <0.05）。COX多因素分析显示，存在B组症状、获得最佳疗效为非CR是影响DLBCL患者预后效果的独立危险因素（P <0.05）。.
结论: DLBCL患者中CD30+表达提示良好的预后，在评估DLBCL患者预后中具有一定的判断价值。.
Keywords: diffuse large B-cell lymphoma; CD30; clinical characteristics; prognosis.