Patients Characteristics
A total of 44 cases with a diagnosis of DLBCL, 24 male, 20 female, diagnosed as a result of lymph node biopsy in Kocaeli University Medical Faculty Hospital, Hematology Department between June 2007 and September 2014 and 6 male and 7 female, totally 13 lymphadenopathy pathology preparations compatible with reactive hyperplasia were taken as the control group.
The mean age was found to be 60.55±11.23 years (median 60 years) in the patient group and 42.53±14.52 years (median 44 years) in the control group. Table 1 presents clinical and laboratory characteristics of the patient and control groups. When the patients were evaluated as per the IPI score, it was observed that 31.8% were low risk, 27.3% low-intermediate risk, 27.3% high-intermediate risk, 13.6% high risk. When we examine the treatment protocols given to the patients in the primary care, 35 patients (79.5%) R-CHOP (Rituximab, Cyclophosphamide, Adriamycin, Vincristine, Prednisolone) , 2 patients (4.5%) RCVP (Rituximab, cyclophosphamide, vincristine, methyl prednisolone), 2 patients (4.5%) CHOP (Cyclophosphamide, adriamycin, oncovin, prednisone), 1 patient (2.3%) CVP (cyclophosphamide, vincristine, methylprednisolone), 1 patient (2.3%) received cyclophosphamide and methylprednisolone. VEGF, PDGFR- and thrombospondin staining rates were depicted in Table-2. It was observed that staining with PDGFR-β was statistically significantly lower in the patient group compared to the control group (p=0.009). In terms of staining with thrombospondin-1, a low rate of staining was found in 41 (93.2%) of the patients and a high rate of staining in 3 patients (6.8%). In the control group, low staining was detected in 12 patients (92.3%) and high staining in 1 patient (7.7%). No statistically significant difference was found between the two groups in terms of thrombospondin-1 staining rates.
When the statistical relationship between VEGF, PDGFR-β, Thrombospondin was investigated, a significant relationship was found between PDGFR-β and Thrombospondin (p = 0.003, r = -0.440). Table-3 presented comparison of the general characteristics of the patients and the staining rates of VEGF, PDGFR-Β and Thrombospondin-1. It was observed that as the PDGFR-β staining rate increased, it was observed the thrombospondin-1 staining rate decreased. VEGF was found to be stained at a statistically significant higher rate in men than in women (p = 0.029). When the VEGF, PDGFR-β, thrombospondin-1 staining ratios of the patients and IPI score , whether they have B symptoms, disease stage, bone marrow involvement, hepatomegaly, splenomegaly, bulky disease, extranodal involvement, refractory to primary care and relapse were compared, no statistically significant difference was found. It was observed that PDGFR-β was less stained in patients with high IPI score and stage. Although those with a high PDGFR-β staining rate were mostly female, the rate of males was higher in low staining rates. Less bone marrow involvement, hepatomegaly, splenomegaly, bulky disease, extranodal involvement and relapse were found in patients with high PDGFR-β staining. However, no statistically significant relationship was observed. Although most of the thrombospondin-1 stained ones were male, all of those highly stained were male. All patients with high thrombospondin-1 staining had B symptoms, and none of them had bone marrow involvement, hepatomegaly, bulky disease, extranodal involvement, refractoriness to treatment, or relapse.
Considering in terms of VEGF staining rates, the estimated 5-year OS in low-stained and high-stained patients was 71% in both groups. While the estimated 5-year PFS value was found to be 63% in low stained patients, it was 73% in high stained patients. Although it was not statistically significant in those highly stained with PDGFR-β, a decrease in both OS and PFS values was observed in the 5-year estimate. In the PDGFR-β low staining group, the estimated 5-year OS was 72% PFS was 69%, while the OS was found as 70% and PFS was 45% in the high staining group. The 5-year OS was found to be 66% in the thrombospondin-1 high-staining group, compared to 72% in the low-stained patients (Table 4).