Clinical characteristics and prognostic features of 63 HIV-associated diffuse large B-cell lymphoma: a single-center real-world study in China / 中华血液学杂志

Objective: This study aimed to look into the clinical characteristics and prognosis of patients with human immunodeficiency virus (HIV) -associated diffuse large B-cell lymphoma (DLBCL) . Methods: Retrospective review of the clinical data of 63 HIV-infected patients with DLBCL diagnosed at Chongqing University Cancer Hospital between July 2008 and August 2021. The Kaplan-Meier method was used to calculate survival curves, and the log-rank test method was used to compare survival between groups. The Cox proportional hazards model was used for multivariate analysis. Results: In 63 patients with HIV-associated DLBCL, 57 (90.5% ) were men, and the median age was 49 (23-87) years. The most common pathological subtype was the germinal center B-cell-like lymphoma (74.6% ) ; 46.0% (29/63) were combined with extranodal lesions. Seventeen of 63 (27.0% ) patients had large masses (≥7.5 cm) . Twenty of 63 (31.7% ) patients had B symptoms. The median CD4(+) T cell count was 203 (4-1022) ×10(6)/L. A total of 49% (25/51) patients had CD4(+) cell count <200×10(6)/L, 56.9% (33/58) had high (3-5) International Prognostic Index (IPI) scores, and 43.1% (25/58) had low (0-2) IPI scores. Further, 78% (46/59) were diagnosed with Ann Arbor Stage Ⅲ/Ⅳ, and 25.4% (16/63) didn't receive chemotherapy. A total of 22.2% (14/63) of patients received less than four cycles of chemotherapy, and 52.4% (33/63) received four or more cycles of chemotherapy. Among patients undergoing chemotherapy, 61.7% (29/47) received R-CHOP-like regimens, and 38.3% (18/47) used CHOP-like regimens. The 1-, 2-, 3-, and 5-year overall survival (OS) rates were 65.0% , 53.8% , 47.1% , and 43.5% , respectively. Univariate analysis revealed that age ≥ 60 years (P=0.012) , Eastern Cooperative Oncology Gruop Performance Status (ECOG-PS) score 2-4 points (P=0.043) , IPI score 3-5 points (P=0.001) , β(2)-MG elevation (≥5.5 mg/L) (P=0.007) , and systemic chemotherapy cycles less than four times (P<0.001) were the negative prognostic factors affecting the OS of patients. The Cox multivariate analysis depicted that age ≥60 years (HR=2.272, 95% CI 1.110-4.651, P=0.025) , IPI score 3-5 points (HR=3.562, 95% CI 1.794-7.074, P<0.001) , ECOG-PS score 2-4 points (HR=2.675, 95% CI 1.162-6.153, P=0.021) , and number of cycles of chemotherapy<4 (HR=0.290, 95% CI 0.176-0.479, P<0.001) were independent risk factors for adverse prognosis of OS. Conclusion: HIV-associated DLBCL is the most common HIV-related tumor, is most commonly seen in men, and has a high 1-year mortality rate. Chemotherapy combined with antiretroviral therapy can improve patient prognosis.

Monomorphic epitheliotropic intestinal T-cell lymphoma: A clinic-pathologic study of 3 cases and literature review / 解放军医学杂志

Objective To summarize the clinicopathological features of monomorphic epitheliotropic intestinal T cell lymphoma (MEITL),and provide the experiences and lessons for diagnosis and treatment.Methods The clinical manifestations,histopathological and immunohistochemical characteristics,diagnosis,treatment and prognosis of 3 cases of MEITL were analyzed retrospectively.Meanwhile,the other cases published in the literatures were reviewed and summarized.Results Two cases of middle aged and aged men and one young woman were reported in present paper.These lesions of all the 3 patients were at the small intestine,of which the female patients had skin and mammary gland involvement.The clinical manifestations were abdominal distention,mulligrubs and intestinal perforation,and the main pathological feature was the diffuse infiltration of the homogeneous tumor cells in the whole layer intestinal wall.Immunohistochemical examination showed that tumor cells expressed all T cell markers CD3,CD8,CD56,T cell cytoplasmic antigen (TIA-1),CD4 and CD5,and Ki-67 proliferation index was 50％-70％.As to the treatment,case 1 received CHOP and GDP regimens successively,and died 2 years after final diagnosis.Case 2 received CHOP regimen for 1 course of chemotherapy and died of giving up treatment.Case 3 gave up treatment,voluntary discharged and then lost.It is clear according to the previous literatures and our experiences that the MEITL possesses high invasiveness and low incidence,and makes the diagnosis difficult;the patient's response to the current treatment is poor.Conclusions MEITL is prone to be in the small intestine.The diagnosis of MEITL should be based on clinical manifestations,pathological features and immunohistochemical detection results.MEITL is rare,the course of disease progresses rapidly,and the patients have the tendency to have intestinal perforation and poor prognosis.Early diagnosis and positive chemotherapy may lead to a better prognosis.

The effect of pro-angiogenic factors and their receptors on angiogenesis in hepatocellular carcinoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To explore the effect of pro-angiogenic factors and their receptors on angiogenesis in hepatocellular carcinoma.</p><p><b>METHODS</b>Expression of VEGF/KDR and Angiopoietins/Tie2 was detected by RT-PCR and Western blot in 15 cases with hepatocellular carcinoma, 15 tumor adjacent tissues (<1 cm, >5 cm), 8 cirrhotic liver, and 4 normal liver. Immunohistochemistry (IHC) was used to detect CD34 expression, and the relationship between neovascular density and angiogenesis was analyzed.</p><p><b>RESULTS</b>The expression levels of VEGF and Ang2 were significantly higher in hepacellular carcinoma group than those in the other groups (P < 0.01), and so did the expression of CD34. The expressions of KDR and Ang1/Tie2 showed no significant difference in all groups, but they indeed increased to various levels in tumor and tumor adjacent tissues as compared with those in cirrhosis and normal liver.</p><p><b>CONCLUSION</b>VEGF/KDR and Angiopoietins/Tie2 may be the crucial signal pathways in the development of hepatocellular carcinoma.</p>