Ki-67、p53、bel-2的表达与恶性淋巴瘤自体造血干细胞移植预后的相关性

Study of the expression of Ki-67, p53, bcl-2 related with prognosis of patients with malignant lymphoma after the autologons hematopoietic stem cell transplantation

目的研究bcl-2、p53、Ki-67在恶性淋巴瘤组织中的表达以及与自体造血干细胞移植（AHSCT）预后的相关关系。方法采用免疫组织化学IHC法检测33例行AHSCT治疗的患者淋巴瘤组织切片中Ki-67、p53、bcl-2的表达。并分析Ki-67、p53、bcl-2的表达与预后的相关性。生存率统计采用Kaplan-Meier生存曲线，Log-Rank检验，多因素分析采用COX风险回归模型。结果p53的表达与33例AHSCT患者预后无关，bcl-2阳性表达组和阴性表达组移植后3年无瘤生存率（DFS）分别为35．71％和88．89％（P〈0．05）；Ki-67阳性表达组和阴性表达组3年DFS分别为43．75％和85．71％（P〈0．05），提示bcl-2和Ki-67的表达与AHSCT的预后相关。COX多因素分析显示，Ki-67和bcl-2是影响淋巴瘤患者AHSCT后无瘤生存的相关因素（P=0．0437）。结论bcl-2、Ki-67蛋白阳性表达的淋巴瘤患者，AHSCT后易复发，可作为移植后预后判断的指标之一。Ki-67和bcl-2是影响淋巴瘤患者AHSCT无瘤生存的独立相关因素。

Objective To evaluate the expression of bcl-2, p53, Ki-67 in malignant lymphoma （ML） and the relationship between the expression of bcl-2, Ki-67, p53 and prognosis for the patients who were given autologous hematopoietic stem cell transplantation （AHSCT）. Methods The expression of bcl-2, Ki-67, p53 were measured by immunohistochemistry （IHC） on paraffin-embedded slices in 33 cases of ML who received AHSCT. Survival analysis was done by the Kaplan-Meier method and Log-Rank test. Multivariate analysis was carried out using COX proportional hazard model. Results For patients with ML who received AHSCT, the 3-year disease free survival （DFS） of bcl-2（＋） group was 35.71%, while that bcl-2 （-） group was 88.89 %. There was significant difference of DFS between the two groups. Meanwhile, for these patients, the 3-year DFS of Ki-67（＋） and Ki-67（-） were 43.75 % and 85.71%, respectively （P 〈0.05）. Multivariate analysis showed that the expression of bcl-2 and Ki-67 were the independent prognostic factors. Conclusion The expression of bcl-2 and Ki-67 were closely related with relapse after AHSCT in patients with ML. They were useful molecular makers for predicting the prognosis of patients with ML after AHSCT.