叉头转录蛋白P1在胃黏膜相关淋巴样组织淋巴瘤中的表达及意义

Expression and clinical significance of FOXPI in gastric MALT lymphomas

目的探讨胃黏膜相关淋巴样组织淋巴瘤中叉头转录蛋白P1的表达水平与组织学形态的相关性及其对预后的影响。方法对43例胃黏膜淋巴组织样淋巴瘤进行组织形态学观察，分析叉头转录蛋白P1和核因子κB（NF—κB）表达与临床病理因素及预后的关系。结果胃黏膜相关淋巴样组织淋巴瘤中叉头转录蛋白P1阳性表达率为44％（19／43），其中强阳性7例，中度阳性12例。单形组叉头转录蛋白P1阳性4例，多形组15例，两组之间比较差异有统计学意义（15％比88％，P〈0．01）。术后复发病例均为叉头转录蛋白P1强阳性者，与叉头转录蛋白P1阳性表达率密切相关（P〈0．05），且NF—κB与叉头转录蛋白P1阳性表达率密切相关（P〈0．01）。多形组的中位生存时间（26个月）明显短于单形组（123个月）（P〈0．01），叉头转录蛋白P1阴性者中位生存时间显著长于核表达中度及核表达强者（115个月比55个月比12个月）（P〈0．05），NF—KB核阳性者的中位生存时间明显短于阴性者（26比131个月）（P〈0．01）。Ⅰ期及Ⅱ期的中位生存时间（98个月及121个月）显著长于ⅡE＋Ⅳ期病例（33个月）（P〈0．01）。多因素COX回归分析显示，叉头转录蛋白P1表达水平和临床分期为胃黏膜相关淋巴样组织淋巴瘤预后的风险因素。结论叉头转录蛋白P1有可能成为判定胃黏膜相关淋巴样组织淋巴瘤恶性转化及预后的一个指标。

Objective To investigate the expression of forkhead box protein P1 （FOXP1） in gastric mucosa-associated lymphoid tissue （MALT） lymphomas and its relationship with histological morphology and prognosis. Methods In this study, samples of 43 MALT lymphoma were studied histologically and divided into monomorphic histology group and polymorphic histology group according to their cellular features. The expressions of FOXP1 and NF-κB in gastric MALT lymphoma were evaluated immunohistochemically by two-step method of Envision, and the clinicopathological features and prognosis were analyzed retrospectively. Results The nuclear expressions of FOXP1 in 43 cases with gastric MALT lymphoma were 44% （19 of 43 ）, including strong immunoreactivity in 7 cases and moderate immunoreactivity in 12 cases. There were g cases with positive immunoreactivity in monmorphic histology group and 15 cases in polymorphic histology group, and the difference was statistically significant （15% vs. 88%, P 〈0. 01 ）. All the postoperative recurrent cases were strongly positive with FOXP1 stain, and it was closely with FOXP1 expression （ P 〈 0.01 ）. The median survival time （ 26 months ） in polymorphic histology group was significantly shorter than that （123 months） in monmorphic histology group （P 〈0. 01 ）, and the median survival time was significantly longer in negative FOXP1 expression group than that in moderate FOXP1 expression group and in strong FOXP1 expression group （ 115 vs. 55 vs. 12 months） （ P 〈 0.05 ）, similarly, the median survival time in nuclear factor kappa B （NF-κB） expression group was significantly shorter than that in negative NF-κB expression group （26 vs. 131 months） （P 〈0. 01 ）. The median survival time in stage Ⅰ （98 months） and stage Ⅱ （ 121 months） was significantly longer than that in stage ⅡE ＋ Ⅳ （33 months ） （P 〈 0. 01 ）. By multivariate COX regression analysis, FOXP1 nuclear expression and clinical stage were independently prognostic factors. Conclusion FOXP1 expression may be used as a biomarker for the assessment of malignant transformation to diffuse large B-cell lymphoma （DLBCL） and predicting prognosis.