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Diffuse large B-cell lymphoma (DLBCL) is a group of heterogeneous diseases, and further classification is of great value for prognostic stratification. In recent years, some subtypes with poor prognosis have been recognized, such as "double-hit" lymphoma or "double-expressing" lymphoma. In addition, the new molecular classification provides a new perspective for the accurate diagnosis and prognosis stratification of DLBCL. The mutation and deletion of p53 gene are high risk factors in the traditional sense of DLBCL, while with the application of the next generation sequencing and other technologies, the influence of more accurate gene mutation or deletion on prognosis and its prognostic value in new cell molecular subtypes still need to be further confirmed. This paper reviews the progress of cell phenotypes and molecular subtypes as well as p53 gene abnormalities in the prognosis of DLBCL.
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Objective:To investigate the clinicopathological and molecular biological characteristics of patients with plasma cell tumor.Methods:The data of bone marrow fluid, bone marrow tissue, peripheral blood and urine specimens of 84 patients with plasma cell tumor from January 2016 to October 2018 in Shanxi Provincial People's Hospital were collected. Bone marrow fluid was examined by using bone marrow smear, karyotype analysis, fluorescence in situ hybridization (FISH), immunophenotyping, and next-generation sequencing (NGS). In addition to the observation of cell morphology, peripheral blood together with urine specimens was also determined by using immune-fixation electrophoresis and free light chain examination. Bone marrow tissue was used to observe the structure and fibrosis of bone marrow, and relevant histochemistry and immunohistochemistry was also performed.Results:Among 84 patients with plasma cell tumor, 2 patients (2.4%) were monoclonal gammopathies of un-determined significance (MGUS), 78 patients (92.8%) were multiple myeloma (MM) (38 cases were IgG Kappa type, 33 cases were IgG Lambda type, 2 cases were IgA Kappa type, 1 case was IgA Lambda type, 3 cases were light chain type, 1 case was non-secretory type), 3 cases (3.6%) were Waldenstrom macroglobulinemia (WM), and 1 case (1.2%) was non-secretory myeloma (NSM). The proportion of abnormal plasma cells detected by bone marrow smear was 0.132-0.676 in 81 patients, and the proportion of abnormal monoclonal plasma cells detected by flow cytometry (FCM) was 1.1%-52.4% in 79 patients. Immunohistochemistry and FCM detection of bone marrow showed positive or weak positive results of CD38 and CD138. Complex karyotype was rare in karyotype analysis. FISH examination showed IGH isolation in 24 patients (28.6%) and gene detection showed 1 case was positive IGH-CCND1 and 1 case was positive IGH-MAF; 1 case of free light chain examination was positive. The positive rate of NGS was lower.Conclusion:Most plasma cell tumors are IgG type, followed by IgA type. Light chain type of plasma cell tumors is rare, and IgM type and non-secretory type are extremely rare. The morphological manifestations of bone marrow smear cytology in different clone types are different.
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Objective To explore the effect of nursing intervention based on the transtheoretical model and stages of change on breastfeeding knowledge, self-efficacy, and duration of breastfeeding in newly born pregnant women, aimed to provide reference for breastfeeding behavior health education model for pregnant women. Methods The 130 primiparas who came to the hospital graded a class- three of Shanxi Province for perinatal examination were selected as the research subjects from May to June in 2017 , they were divided into test group and control group by random digits table method. In the control group, the normal breastfeeding health guidance was carried out in the three stages of prenatal, hospitalized and after discharge. The test group divided the primipara from the beginning of pregnancy to 6th months postpartum period into 5 stages according to transtheoretical model and stages of change. The new strategy of breastfeeding should be formulated and implemented according to different stages and behavior changing processes. Results The total score of breastfeeding knowledge of primipara were (8.76±1.14), (8.92±1.21), (9.90±1.27), (9.94±1.29) points in control group before intervention, the 3rd day, the 42nd day and the 6th month after delivery, and they were (9.11 ± 1.42), (12.02 ± 1.64), (13.04 ± 1.67), (15.00±1.83) points respectively in test group, the differences were statistically significant(Ftime= 51.823, Fgroup=10.406, Finteractive=56.641, all P < 0.05). The total scores of breastfeeding self-efficacy of primipara were (84.62 ± 1.14), (88.96 ± 1.41), (86.65 ± 1.47), (84.31 ± 1.57) points respectively in control group before intervention, the 3rd day, the 42nd day and the 6th month after delivery, while in test group they were (84.98 ± 1.20), (104.02 ± 1.42), (111.00 ± 1.45), (120.04 ± 1.40) points, the differences were statistically significan (Ftime=12.592, Fgroup=229.674, Finteractive=79.955, all P<0.05). The pure breastfeeding rates of primipara were 60.0％(33/55) , 41.8％(23/55), 21.8％(12/55) in control group on the 3rd day, the 42nd day and the 6th month after delivery, they were 84.7％(50/59), 76.3％(45/59) , 49.2％(29/59) in the test group. The differences was statistically significant (χ2=8.804, 14.038, 9.235, all P <0.01). Conclusion Breastfeeding intervention based on the theory of behavioral staged transition can help primipara to improve breastfeeding knowledge and self-efficacy, and improve breastfeeding status.
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Objective To explore the clinical significance of T lymphocyte subsets and NK cells' detection in peripheral blood of patients with non-Hodgkin' s lymphoma (NHL).Methods 62 newly diagnosed NHL and 30 healthy adults were enrolled for analyzing.T lymphocyte subsets and NK cells were deteced by flow cytometry and compared between different groups according to age,sex and pathology.Multiple linear regression was used to analyze the correlation among the levels of T lymphocyte subsets and NK cells and several clinical factors,such as clinical stage,IPI and B symptoms.Results The proportions of CD3,CD4 and NK cells in peripheral blood of NHL group [(64.13±19.83) ％,(27.10±8.20) ％,(13.51± 10.59) ％] were significantly lower than those of normal control [(65.78±10.69) ％,(31.95±12.74) ％,(18.76± 7.36) ％] (P ＜ 0.05),while the proportions of CD8 and Treg cells in peripheral blood of NHL [(32.15±13.83) ％,(10.44±3.00) ％] were significantly higher than those of normal control [(29.25±12.35) ％,(7.51±4.36) ％] (P ＜ 0.05).In NHL,the proportions of CD3 and NKT cells [(67.06±19.24) ％,(4.91±3.69) ％] in ≤60 years old group were significantly higher than those in ＞ 60 years old group [(59.18±20.33) ％,(4.89±3.05) ％] (P ＜ 0.05).The proportions of Treg cells in T-NHL was significantly higher than that in B-NHL [(8.17±6.41) ％ vs (7.11±2.53) ％] (P ＜ 0.05).The proportions of CD3,CD4,NK and NKT cells in peripheral blood of NHL were significantly correlated with clinical stage (P ＜ 0.05),that of CD8 cells were significantly correlated with IPI (P =0.000),that of Treg cells were significantly correlated with IPI and B symptoms (P ＜ 0.05).Conclusion The cellular immune is suppressed in NHL patients.The proportions of T lymphocyte subsets and NK cells in peripheral blood of patients with NHL are different between different groups according to age,sex and pathology.The correlations among that and clinical factors need to be further explored.
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Objective To study the effect and safety of GDP regimens (gemcitabine,cisplatin,dexamethasone) as salvage chemotherapy in relapsed refractory non-Hodgkin’s lymphoma (NHL).Methods Clinical response and adverse effects of 34 NHL patients treated by GDP regimens were analyzed retrospectively.Results The overall response rate (ORR) was 52.9 ％ (18/34),there was no statistic difference between ORR in relapsed NHL [72.7 ％ (8/11)] and that in refractory ones [43.5 ％ (10/23)](P =0.11).The ORR for B-NHL was 64.0 ％ (16/25),while for T-NHL was 22.2 ％ (2/9),there was no statistic difference between them (P =0.052).The ORR for low risks groups was 66.7 ％ (6/9),while it for intermediate-risk and high-risk ones were 55.6 ％ (10/18) and 28.6 ％ (2/7),respectively,the effect of GDP regimens for low-risk group was better for high-risk ones,but there was no statistic difference (P =0.349).The incedience of Ⅲ-Ⅳ granulopenia reduced was 23.5 ％ (8/34) and there were no Ⅲ-Ⅳ gastrointestinal adverse reactions or liver and kidney toxicity.Conclusion GDP regimens were efficient and less toxic as second-line salvage chemotherapy.
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Background and purpose: Germline variation in Tg (thyroglobulin) and TSHR (thyroid stimulating hormone receptor) confers an increased risk of benign thyroid disorders. Benign thyroid disorders are strong risk factors for non-medullary thyroid cancer (NMTC). To explore the hypothesis that polymorphic variation in these genes affects the risk of NMTC. Methods: Tg A7589G and TSHR C253A polymorphisms were determined by polymerase chain reaction-restriction fragment length polymorphism (FCR-RFLP) method, to analyze the relationship between the Tg and TSHR gene polymorphisms and NMTC in NMTC and control groups. Results: Among 360 cases, there was no statistic difference in the frequencies of genotype and allele of TSHR C253A between NMTC and control groups. There were Tg A7589G polymorphisms in the 360 cases. The frequencies ofAG+GG genotype in NMTC group were significantly higher than those in control groups (P<0.05). The frequencies of G allele in NMTC group were significantly higher than those in control groups (P<0.001). Conclusion: There were Tg A7589G gene polymorphisms in NMTC and control groups. G allele may be the predisposing gene of NMTC.
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Objective To investigate the change of CD_4~+CD_(25)~(high)CD_(127)~(low)> regulatory T cells (Trcg cells) sub-group level in peripheral blood of non-Hodgkin lymphama (NHL) patients, and to explore its clinical significance. Methods Treg cells levels in peripheral blood of lymphoma patients and normal were detected by flow cytometry, followed by statistical analysis. Results In the 65 cases of NHL patients, Treg cells in peripheral blood were (6.72±1.38) %, higher than that in the normal control group (5.65±0.68) % (P 0.05, normal control group (5.65±0.68) %, patients with normal LDH group (6.97±1.20) %, patients with lactate dehydrogenase (6.54±1.02) %]. Conclusion Treg cells induced by tumor and could inhibit the immune cells, Treg cells percentage in peripheral blood of tumor patients is higher than that the normal control group, and increased with the clinical staging, so the percentage of Treg cells may serve as a clinical indicator to evaluate tumor load.
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Objective To test different expression protein markers of the serum from B-cell non-Hodgkin lymphoma(B-cell NHL) between diffuse large B-cell lymphoma(DLBCL) and follicular lymphoma(FL)patients using sudace enhanced laser desorption/ionization-time of flight-mass spectrometry(SELDI-TOF-MS)protein chip technology. Further, to test different expression of the protein markers of B-eell NHL patients after chemical therapy in order to discuss clinical significance. Methods Different expression of protein markers were analysed in serum between 54 B-cell NHL patients and 27 healthy volunteers by using SELDI-TOF-MS WCX-2 pertein chip. Meanwhile different expression of protein markers relative to pathology classification between 23 DLBCL patients and 12 FL patients were screened; and protein markers which affected prognosis of 23 DLBCL patients were screened. Results There were five specific marker proteins in 54 B-cell NHL patients and 27 healthy volunteers. Their relative molecular weights were 7974, 15 938, 3398,8564, and 8692. The protein markers of 7974 and 15 938 were at high level in patients and the protein markers of 3398, 8564 and 8692 were at low level in patients. There were two protein markers which affected the prognosis, with better outcome when the expression of 4795 and 4998 were increased. Conclusion SELDI-TOF-MS protein chip technology is a quick, easy and convenient method, with high-throughput analyzer which can screen several relatively specific protein markers from the serum of patients to diagnose B-cell NHL The relatively specific protein markers can be used to make pathology classification and to judge the prognosis of B-cell NHL, and have better clinical value.
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Objective To research correlation of serum protein spectrometry and lymphoma markers for diffuse large B cell lymphoma (DLBCL) patients. Whether there is relative between the protein and prognosis will be further researched. Methods Serum protein spectrometry of 62 DLBCL patients was detected by the SELDI-TOF-MS technique and Weak cation exchange 2 (WCX2) chip. Lactate dehydrogenase (LDH) was detected by biochemistry method. Beta-2-microglobulin (β2-MG) and cancer antigen125(CA125)were detected by enzyme-linked immunosorbent assay (ELISA). The level of LDH, β2-MG and CA125 for DLBCL patients between 11×103～12×103 protein expressed positively and negatively was analyzed. Meanwhile,correlation analysis and survival analysis were done. Results LDH, β2-MG and CA125 in 11×103～12×103protein expressed positive group were (523.30±435.96)U/L, (3.23±1.24)mg/L, (81.07±61.39)U/L respectively,and they were higher than that in negative group (P＜0.05). 11×103～12×103 protein was positive correlated to LDH, β2-MG and CA125 (P＜0.01). The survival time in 11×103～12×103 protein expressed in positive group,in which median survival time was 11 months, was shorter than that in negative group(P ＜0.01). The survival time in LDH normal group was longer than that in increased group(P ＜0.01). The survival time of β2-MG and CA125 had no significant difference between increased group and normal group. Conclusion LDH and 11×103～12×103 protein are expected to be prognosis indicators for DLBCL patients.