Expression and Clinical Significance of CD68+ Lymphoma Associated Macrophage in Diffuse Large B-Cell Lymphoma

Abstract

Objective To investigate the expression and clinical significance of CD68+ lymphoma associated macrophage (LAM) in diffuse large B-cell lymphoma (DLBCL).Methods From October 2011 to April 2013,a total of 60 cases with DLBCL who were first diagnosed in the First Affiliated Hospital of Nanchang University were collected into this study,as the study group.And 20 cased with lymph node reactive hyperplasia who were first diagnosed in the same hospital during the same period were included into the control group.The number of CD68+ LAM of study group and control group was detected by two-step immunohistochemical staining method,and compared the number of CD68+ LAM among DLBCL patients with different clinical features.The study protocol was approved by the Ethical Review Board of Investigation in Human Being of the First Affiliated Hospital of Nanchang University.Informed consent was obtained from all participants.There were no significant differences of patients' general clinical features between two groups (P＞ 0.05).Results The number of CD68+ LAM among DLBCL patients with different ages,different Ann Arbor stage,with and without spinal cord invasion was different from each other and the differences were all statistically significant (F=2.946,3.798,2.214; P=0.024,0.009,0.043).While there were no statistically significant differences among DLBCL patients with different ages,different serum lactic dehydrogenase levels,with or without B symptom and with or without megalo-lump (P＞0.05).The number of CD68+ LAM in DLBCL patients with different international prognostic index (IPI) scores compared with that in control group,the difference was statistically significant (F=26.522,P＜0.05); And the number of CD68+ LAM in each IPI level group was higher than control group (P＜0.05).Among the 60 cases with DLBCL,there were 13 cases (21.7％) with high-density expression of CD68+ LAM and 47 cases (78.3％) with low-density expression.The therapy efficiency of CD68+ LAM high-density expression group (10/13,76.9 ％) was lower than the low-density expression group (44/47,93.6％),and the difference was statistically significant (Ridit z =12.152,P＜0.05).The median survival time of CD68+ LAM high-density expression group was 22.1 months,while the low-density expression group was 40.1 months,the difference was statistically significant (P ＜ 0.05).Conclusions The expression of CD68+ LAM in DLBCL patients with different malignant degree and prognosis risk differ from each other.And prognosis of DLBCL patients with different expression of CD68+ LAM also differs from each other.Clinical practice may try to use CD68+ LAM as a prognostic indicator of DLBCL. Key words: Lymphoma,large B-cell,diffuse; Macrophages; Lymphoma,non-Hodgkin