原发性胃肠淋巴瘤p53基因与13q14染色体缺失与预后的关系

Association of absence of p53 gene and chromosome 13q14 variation with prognosis of primary gastrointestinal lymphoma

目的探讨p53基因与13@4染色体缺失在原发性胃肠淋巴瘤（PGIL）预后判断、指导治疗中的作用。方法采用改良的荧光标记的原位杂交（FISH）技术检测72例PGII．及30例淋巴结反应性增生患者石蜡切片中p53基因及13q14染色体缺失情况，分析其与PGIL预后的关系。结果①I期～Ⅱ期患者中30．2％（16／53）有p53基因缺失，Ⅲ期～Ⅳ期患者中63．2％（12／19）有p53基因缺失（x2=6．397，p=0．011）；②黏膜相关组织（MALT）淋巴瘤中28．6％（12／42）有p53基因缺失，非MAI，T淋巴瘤中53．3％（16／30）有p53基因缺失（x2=4．515，P=0．034）；③MALT淋巴瘤中，无基因或单基因改变者平均生存期为（39．25±22．73）个月，2种基因改变的患者平均生存期为（9．11±5．95）个月；I期～Ⅱ期患者中，无基因或单基因改变者平均生存期为（40．33±23．18）个月，2种基因改变的患者平均生存期为（20．61±18．90）个月。④单纯13q14缺失与肿瘤发生部位、病理类型、临床分期以及平均生存期无关，但同时合并p53基因缺失则预后差。结论p53基因缺失在非MALT淋巴瘤组及Ⅲ期～Ⅳ期患者中发生率较高。p53缺失或p53基因缺失与13q14染色体同时存在缺失的PGIL病例恶性程度高，患者平均生存期短于无基因或单基因改变者。

Objective To assess the role of p53 gene and absence of chromosome 13q14 in prognosis of primary gastrointestinal lymphoma（PGIL）. Methods The expressions of p53 gene and chromosome 13q14 in paraffin sections from 72 patients with PGIL and 30 patients with lymph node reactive hyperplasia were detected by using improved FISH technique. The association of p53 gene and absence of chromosome 13q14 with PGIL prognosis was analyzed. Results （1） The p53 gene deletion in stage IⅠ-Ⅱ patients was accounted for 30.2% ,which was lower than that in stage Ⅲ-Ⅳ patients （63.2 %, X2 = 6. 397, P= 0.011）. （2） There was significant difference between MALT lymphoma and non-MALT lymphomaas aspect to p53 gene deletion （28. 6% vs 53.3%, X2=4.515, P=0.034）. （3） The average survival time was （39.25±22.73） and （40.33±23.18） months in MALT lymphoma and stage Ⅰ-Ⅱ patients with or without single gene variation respectively, and was （9. 11 ±5.95） and （20.61 ± 18.90） months in MALT lymphoma and stage []] ~ IV patients with two genes variation, respectively. （4） 13q14 deletion was not significantly related to location, pathological type and clinical staging of tumor as well as survival time. However, the prognosis was poor when both 13q14 and p53 deleted. Conclusions There is a high incidence of p53 gene deletion in non-MALT lymphoma and stage Ⅲ-Ⅳ patients. Those who have p53 gene and chromosome 13q14 abnormalities are of high degree of malignant,and the average survival time is shorter than patients with or without single gene deletion.