弥漫性大B细胞淋巴瘤（DLBCL）是最常见的高度异质性非霍奇金淋巴瘤（NHL）,不同的疾病阶段或临床亚型预后不尽相同。放射治疗作为无交叉耐药的理想局部治疗技术,应用于DLBCL可有效改善患者预后。初治DLBCL通过放射治疗联合化学治疗、免疫治疗等综合治疗可使约60%~70%患者疾病缓解。对于不同预后影响因素,如年龄、肿瘤体积、淋巴结外侵犯等,联合放射治疗也可取得更佳疗效。在复发性/难治性DLBCL的治疗中,自体造血干细胞移植（ASCT）和嵌合抗原受体T细胞免疫治疗（CAR-T）是目前的研究热点,而放射治疗无论是作为ASCT与CAR-T术前的桥接治疗或失败后的挽救性治疗均有助改善患者预后。随着放射治疗技术的日益优化,放射治疗在综合治疗方案中扮演着越来越重要的角色。

Diffuse large B-cell lymphoma（DLBCL）is a highly heterogeneous type of non-Hodgkin lymphoma（NHL）and its prognosis is different for different disease stages or clinical subtypes．Radiation therapy（RT）is a local treatment technique that does not cause cross-resistance and can effectively improve the prognosis of patients with DLBCL．When combined with chemotherapy and immunotherapy,RT can alleviate the disease in more than 60% of patients．Furthermore,RT can achieve better results for different prognostic factors such as age,tumor volume and external nodal invasion．For treating relapsed / refractory DLBCL,autologous stem cell transplantation（ASCT）and chimeric antigen receptor T cell immunotherapy（CAR-T）are currently being researched,while RT can help as bridging therapy before ASCT and CAR-T or salvage therapy after failure．With the increasing optimization of technology,radiotherapy plays an increasingly important role in combined treatment options．

目的 探讨Yes1相关蛋白（YAP）及p65在弥漫大B细胞淋巴瘤（DLBCL）中与临床特征的相关性及对DLBCL治疗和预后的意义。方法 收集65例DLBCL和10例反应性增生淋巴结患者组织进行免疫组织化学染色,分析两组差异;对多种临床特征与YAP、p65的相关性进行统计学和生存差异性分析。结果 YAP、p65染色评分在两组间比较差异有统计学意义（P<0.05）;YAP评分与疗效分组呈正相关,与治疗前乳酸脱氢酶（LDH）、Ann-Arbor分期、国际预后指数（IPI）呈负相关（P<0.05）;p65表达与疗效分组呈负相关,与治疗前LDH水平、Ann-Arbor分组、美国东部肿瘤协作组活动状态评分（ECOG）ECOG分组、结外侵犯、IPI评分、巨大包块呈正相关（P<0.05）。IPI及p65评分是DLBCL患者总生存期（OS）的独立危险因素（P<0.05）。共表达分层中YAP-/p65⁺组患者OS均值最低。结论 对于DLBCL,YAP低表达或p65高表达提示患者瘤荷较大、较差的疗效和预后。

Objective To investigate the correlation of YAP and p65 with clinical features in diffuse large B-cell lymphoma（DLBCL）and the significance for treatment and prognosis．Methods Tissues from 65 patients with DLBCL and 10 patients with reactive hyperplasia lymph node were collected for immunohistochemistry staining to analyze the differences between the two groups;statistical analysis and survival difference analysis of the correlation between various clinical features and YAP,p65 were performed．Results YAP and p65 staining scores were significantly different between the two groups（P<0.05）．YAP scores were positively correlated with efficacy subgroups,and negatively correlated with LDH levels before treatment,Ann-Arbor staging,and International Prognostic Index（IPI）scores before treatment（P<0.05）;p65 expression was negatively correlated with efficacy subgroups,and positively correlated with pretreatment LDH levels,Ann-Arbor subgroup,ECOG subgroup,extra-nodal invasion,IPI scores,and huge mass（P<0.05）．IPI and p65 score were independent prognostic risk factors for overall survival（OS） in DLBCL patients（P<0.05）．The mean value of OS was the lowest in patients in the YAP-/p65⁺ group in the co-expression stratification．Conclusions Low expression of YAP or high expression of p65 suggests larger tumor load and poorer outcome and prognosis in patients for DLBCL．