核转录因子-κB在原发性胃肠道弥漫性大B细胞淋巴瘤中的表达及临床意义

Clinical signif icance of nuclear factor κB expression in primarygastrointestinal diffuse large B-cell lymphoma

目的:探讨原发性胃肠道弥漫性大B细胞淋巴瘤(PGI-DLBCL)中核转录因子κB(NF-κB)的表达及临床意义.方法:采用免疫组织化学方法检测PGI-DLBCL患者中CD10、Bcl-6、Mum-1、NF-κBp65的表达,结合临床随访资料,分析NF-κBp65与PGI-DLBCL免疫分型、临床生物学行为及预后的关系.结果:PGI-DLBCL中CD10阳性15例(28%),Bcl-6阳性37例(69%),Mum1阳性44例(81%),将其分为生发中心B细胞型(GCB型)19例(35%),活化B细胞(ABC型)35例(65%).NF-κBp65阳性表达率为72%(39/54),ABC型中NF-κBp65的表达率明显高于GCB型(74.4%vs25.6%,P<0.05).PGI-DLBCL中NF-κBp65的表达程度与结外侵犯部位有显著差异(P<0.05),其阳性表达率在结外侵犯部位中"≥2"组的77%(10/13)表达强度大于"0-1"组的71%(29/41)(P<0.05).NF-κBp65表达阴性患者平均生存期明显长于阳性组(45.8mo±35.9movs20.3mo±29.3mo,P<0.05).结论:NF-κBp65和ABC型呈正相关,和PGI-DLBCL的发展和侵袭有关,对PGI-DLBCL预后判断具有一定临床意义,在PGI-DLBCL的高表达可作为新的治疗靶点.

AIM：To investigate the clinical significance of nuclear factor κB（NF-κB） expression in primary gastrointestinal diffuse large B-cell lymphoma（PGI-DLBCL）.METHODS：Immunohistochemical staining was used to detect the expression of CD10,Bcl-6,Mum-1 and NF-κB p65 in PGI-DLBCL.The relationship of NF-κB p65 expression with tumor subtype,biological behavior and prognosis was analyzed.RESULTS：Of 54 cases of PGI-DLBCL detected,28% were positive for CD10,69% positive for Bcl-6,and 81% positive for Mum-1;19 were clas-sified as germinal center B-cell-like（GCB） subtype,and 35 as activated B-cell like（ABC） subtype.The positive rate of NF-κB p65 expression in PGI-DLBCL was 72%（39/54）.The positive rate of NF-κB p65 expression was significantly higher in ABC-DLBCL than in GCB-DLBCL（74.4% vs 25.6%,P0.05）.NF-κB p65 expression was correlated with extranodal invasion site in PGI-DLBCL（P0.05）.The overall survival time of NF-κB p65-negative PGI-DLBCL patients was longer than that of NF-κB p65-positive ones（45.8 mo ± 35.9 mo vs 20.3 mo ± 29.3 mo,P0.05）.CONCLUSION：NF-κB p65 expression was positively correlated with the subtype,development,and invasion of PGI-DLBCL.NF-κB p65 can be used as a prognostic factor for PGI-DLBCL and may represent a new molecular target for the therapy of GI-DLBCL.