转录因子IRF4/MUM1在弥漫性大B细胞淋巴瘤中的表达及其临床意义

Clinical significance of transcriptional factors IRF4/MUM1 expression in diffuse large B-cell lymphoma

目的:探讨转录因子IRF4/MUM1在弥漫性大B细胞淋巴瘤中的表达与转录因子BCL6的关系及其临床意义。方法:选择弥漫性大B细胞淋巴瘤患者95例,免疫组织化学方法检测IRF4/MUM1和BCL6的表达,Kaplan-Meier方法分析其临床意义。结果:61.1%(58/95)的弥漫性大B细胞淋巴瘤表达IRF4/MUM1,46.3%(44/95)表达BCL6,58例IRF4/MUM1阳性患者中51.7%(30/58)同时表达BCL6;IRF4/MUM1表达以及与BCL6同时表达与患者的年龄、Ann Arbor分期、结外病变累及数目、LDH水平以及国际预后指数危险度均相关;Kaplan-Meier生存分析显示IRF4/MUM1阳性患者的无病生存率显著低于阴性患者,总体生存率两者无显著差别;IRF4+/BCL6+组的无病生存率和总体生存率均显著低于IRF4-/BCL6+组。结论:弥漫性大B细胞淋巴瘤患者IRF4/MUM1蛋白表达比例较高,且可同时表达BCL6;IRF4/MUM1蛋白表达提示弥漫性大B细胞淋巴瘤患者的不良预后,这在同时表达BCL6的患者中更显著。

Objective：To explore the expression of transcriptional factors IRF4/MUM1 and its association with BCL6 expression in diffuse large B-cell lymphoma （DLBCL） and evaluate their clinical significance. Method.. Ninety-five DLBCL patients were enrolled in this study. Expession of IRF4/MUM1 and BCL6 were detected in paraffin-embedded tissues by immunohistochemistry. Result： IRF4/MUM1 and BCL6 protein were found in 61.1% （58/95） and 46.3%（44/95） of DLBCL patients, respectively. 51.7%（30/58） of patients was with co-expression of IRF4/MUM1 and BCL6. IRF4^＋ and IRF4^＋/BCL6^＋ were related to adverse prognostic factors, such as age〉 60, advanced Ann Arbor stage, extranodal involvement site〉1, increased LDH level and high-risk IPI. Kaplan- Meier survival analysis showed that event-free survival in IRF4＋ patients was significantly shorter than those negative for IRF4. Moreover, in BCL6^＋ group, both event-free survival and overall survival were shorter in IRF4 （＋）/BCL6（＋） cases, comparing with IRF4 （-）/BCL6 （＋） cases. Conclusion： More than half of the DLBCL patients expressed IRF4/MUM1. IRF4/MUM1 protein indicates poor disease outcome in DLBCL. This adverse prognostic effect was particularly seen in patients accompanying by BCL6 expression.