ABSTRACT
OBJECTIVE@#To investigate the clinicopathological features of intestinal diffuse large B-cell lymphoma (DLBCL).@*METHODS@#The clinical features, pathological morphology, immunophenotype, and EBER in situ hybridization of 136 DLBCL patients diagnosed in Jinan People's Hospital Affiliated to Shandong First Medical University from January 2007 to October 2014 were analyzed retrospectively. A total of 136 DLBCL samples were obtained, the DLBCL sites were categorized as: duodenum (n=23), ileocecal region (n=63), other small intestine (n=29), rectum (n=7), and other large intestine (n=14). Survival curves for the DLBCL patients were plotted using the Kaplan-Meier method and judged by the Log-rank test.@*RESULTS@#Patients with DLBCL of the ileocecal region and other small intestine except duodenum were mainly male (P=0.042), and had a higher proportion of limited-stage tumors(P=0.015), and lower International Prognostic Index (IPI) (P=0.001). Patients with DLBCL of ileocecal region had higher incidence of lactate dehydrogenase elevation (P=0.007), and higher incidence of intestinal obstruction or perforation (P<0.001) than those with DLBCL of other regions. The 5-year overall survival and 5-year progression-free survival of patients with DLBCL in ileocecal and other small intestine sites were higher than those in other sites, but the differences were not statistically significant (P=0.135, 0.459). Fifty percent of intestinal DLBCL were germinal center B cell-like (GCB) subtypes. A low-grade B-cell lymphoma was found in 21% of 136 tumor samples. In ileocecal and other small intestinal specimens, the proportion of low-grade B-cell lymphoma was 29%, and the difference was statistically significant(P=0.025). About 16% of 136 DLBCL samples expressed follicular lymphoma while no mucosa-associated lymphoid tissue lymphoma . The Epstein-Barr virus-encoded RNA-1 (EBER1) positive rate of duodenal DLBCL was significantly higher than that of other sites (5/23, 22% vs 2/63, 3%, P=0.001).@*CONCLUSION@#The intestinal DLBCL is commonly observed in male, and ileocecal is the most primary site. Patients with DLBCL of the ileocecal region and small intestine except duodenum have low IPI, high proportion of limited-stage tumors, low level of lactate dehydrogenase, high incidence of intestinal obstruction or perforation, and low incidence of inert lymphoma. The EBER1 positive rate of DLBCL in duodenal is higher.
Subject(s)
Humans , Male , Epstein-Barr Virus Infections , Herpesvirus 4, Human , Lymphoma, Large B-Cell, Diffuse , Prognosis , Retrospective StudiesABSTRACT
<p><b>OBJECTIVE</b>To explore the curative efficacy of methotrexate(MTX) combined with rituxan for treating patients with primary central nervous system(CNS) lymphoma.</p><p><b>METHODS</b>One hundred patients with primary CNS lymphoma in our hospital were randomly divided into targeted treatment group(50 cases) and traditional treatment group (50 cases). Targeted treatment group adopted the therapy of high-dose methotrexate combined with rituxan, the traditional treatment group adopted the high-dose methotrexate combined with whole brain radiotherapy. The results of relevant imaging examination, clinical data, imaging, follow-up and the survival time were analysed and compared between these 2 groups.</p><p><b>RESULTS</b>In the targeted therapy group, there were 33 cases in CR, 9 cases were in stable condition, and 5 cases were in partial response, and 3 cases in the progressive stage. In the group of traditional treatment group, 29 cases reached complete remission, 5 cases were in stable condition, 11 cases were in partial response, and 5 cases were in the progressive stage. In the targeted treatment group and traditional treatment group, the median progression-free survival time was 28 and 11 months, respectively.</p><p><b>CONCLUSION</b>The first choice for treatment scheme of PCNSL is high-dose methotrexate chemotherapy combined with whole brain radiotherapy, that showed a certain curative effect, but the adverse reactions are larger, and a big late neuro toxic reaction may occur, while high-dose methotrexate combined PCNSL rituxan treatment shows high curative effect, less adverse reaction and low side effects. This treatment also has a more positive value for the elderly patients with PCNSL.</p>
ABSTRACT
OBJECTIVE:To observe the effects of Paclitaxel,Cisplatin combined with Recombinant human (Rh) endostatin on the efficacy and related indexes of patients with non-small cell lung cancer(NSCLC). METHODS:78 patients with Ⅲb or ⅣNSCLC were randomly divided into control group(39 cases)and observation group(39 cases). Control group received Paclitaxel injection 135-175 mg/m2,d1,intravenous infusion,once a day+Cisplatin injection 25 mg/m2,3 times a day,d1-3,intravenous infu-sion. Observation group additionally received Rh endostatin injection 15 mg/m2,adding into 500 ml 0.9% Sodium chloride injec-tion by slow intravenous infusion 3-4 h,d1-14,then stopped for 7 d. 21 d was regarded as 1 treatment course,it lasted 6 courses. Clinical efficacy,programmed death ligand-1(PD-L1)level,quality of life(QOL)score before and after treatment,and the inci-dence of adverse reactions in 2 groups were observed. RESULTS:All patients completed 2 courses of chemotherapy. There were 3 patients in observation group and 4 patients in control group quitted the study with uncompleted 6 weeks of chemotherapy due to in-tolerance or adverse reactions. The remission rate in observation group was significantly higher than control group,with statistical significance (P0.05). After treatment,PD-L1 level and QOL score in 2 groups were significantly lower than before,and observation group was lower than control group,with statistical significance (P0.05). CONCLUSIONS:Paclitaxel,Cisplatin combined with Rh endostatin can improve the short-term efficacy of patients with NSCLC,inhibit PD-L1 expression,improve QOL,and do not increase the incidence of adverse reactions.