摘要
目的 探讨bcl-6 、p53、c-myc基因异常的检测在弥漫大B细胞淋巴瘤(DLBCL)中的临床意义.方法 间期荧光原位杂交(I-FISH)方法检测59例DLBCL患者活体石蜡组织bcl-6、p53蛋白、c-myc基因异常的情况,同时以CHOP及R-CHOP方案化疗,评价疗效.观察bcl-6、p53蛋白、c-myc基因与化疗疗效及生存期的关系.结果 59例DLBCL中,p53丢失18例(30.5%),bcl-6重排11例(18.6%),c-myc重排5例(8.5%).p53丢失阳性组化疗有效率(33.3%)明显低于阴性组(76.5%)(x2=9.560,P=0.002). bcl-6基因重排阳性组的预后差于基因重排阴性组,但差异无统计学意义[总生存(OS),P=0.107;无进展生存时间(PFS),P=0.094]; p53基因丢失阳性组预后明显差于阴性组(OS,P=0.031;IPFS,P=0.028);c-myc重排阳性组的预后差于基因重排阴性组,但差异无统计学意义(OS,P=0.163;PFS,P=0.167).其中CHOP化疗组患者,p53基因丢失、c-myc重排阳性组的预后明显差于阴性组,差异有统计学意义(P值均< 0.05);R-CHOP化疗组,bcl-6基因重排阳性组具有较差的预后意义(OS,P=0.003;PFS,P=0.007).结论 bcl-6 、p53、c-myc基因异常与 DLBCL预后密切相关,可作为预测DLBCL的预后因素并指导治疗.
Objective To investigate aberrations of bcl-6,p53,c-myc genes in diffuse large B-cell lymphoma (DLBCL) and its clinical significance.Methods Interphase fluorescence in situ hybridization (I-FISH) was detected in 59 DLBCL patients in vivo tissue bcl-6,p53 protein,c-myc gene status.The patients were treated with CHOP or R-CHOP chemotheralpy,and the survival rates and treatment efficiency were compared.Results The p53 deletion was detected in 18 of the 59 cases (30.5 %),bcl-6 rearrangement in 11 cases (18.6 %),5 cases with c-myc rearrangement (8.5 %).In the aspects of remission rate,p53 deletion positive group contained less advantage than negative ones (33.3 % vs 75.6 %,x2 =9.560,P =0.002).The prognosis of bcl-6 gene rearrangement positive group different from negative group,but the difference was not statistically significant (OS,P =0.107; PFS,P =0.094),p53 deletion positive patients was in significantly worse prognosis than the negative group (OS,P =0.031; PFS,P =0.028),c-myc rearrangement positive group difference in gene rearrangement negative group,but the difference was not statistically significant (OS,P =0.163; PFS,P =0.167).In the CHOP group,prognosis of p53 deletion,c-myc rearrangement positive group were significantly worse than the negative group,the difference was statistically significant (P 〈 0.05).In R-CHOP group,the prognostic significance of bcl-6 gene rearrangement positive group were worse (OS,P =0.003; PFS,P =0.007).Conclusion DLBCL patients with bcl-6,p53,c-myc genes aberrations are related with poor prognosis,and they can be used as prognostic factors for predicting DLBCL and guiding therapy.
出处
《白血病.淋巴瘤》
CAS
2013年第11期661-664,共4页
Journal of Leukemia & Lymphoma