摘要
目的探讨检测MYC、Beb2和Bcl-6在弥漫性大B细胞淋巴瘤患者预后判断中的价值。方法回顾性分析郑州人民医院2007—06—01—2009—06一01确诊的159例弥漫性大B细胞淋巴瘤组织标本,间期荧光原位杂交方法检测MYC断裂、IGH/Bcl-2融合及Bcl-6基因断裂;免疫组织化学方法检测MYC、Bcb2及Bc卜6的表达丰度,并分析其与患者免疫学分型及预后的关系。结果国际预后指数(international prognosticindex,IPI)评分较高(IPI为3~5)的患者MYC表达高于IPI评分较低组(IPI为o~2),χ2=1.25;P=0.04;CD5+与生发中心B细胞样(germinal center B-cell-like,GCB)亚型患者的Bcl-2表达增高,χ2值分别为2.22和13.70,P值分别为0.001和0.002;Bcl-6的表达降低,χ2值分别为5.58和7.26,P值分别为0.004和0.007。MYC、Bcl-2低表达均使患者的总生存时间(overall survival,OS)和无进展生存期(progression-free survival,PFS)的风险比(hazard ratio,HR)增加,P值分别为0.005、0.016、0.003和0.001,Bcb6的高表达使患者的PFS的HR增加,P=0.035;IPI评分较低患者较评分较高患者的OS与PFS的HR增加,P值均为0.001。结论MYC、Bcl-2和Bel-6检测对弥漫性大B细胞淋巴瘤患者的预后具有判断价值,可作为判断顸后的分子标志物。
OBJECTIVE To investigate the prognosis judgment value of MYC/Bcl-2/ Bcl-6 detection in patients with diffuse large ]3 cell lymphoma. METHODS A retrospective analysis of 159 patients with diffuse large B cell lymphoma tissue specimens were conducted in Zhengzhou People's Fiospital from June 1,2007 to June 1,2009. FISH was used to detect the break of gene MYC and Bcl-6 and the fusion of IGH/Bcl-2, the expression levels of MYC, Bcl-6, Bcl-2 in the tumor tissue were detected by immunohistochemistry. The relationship of MYC/Bcl-2 break and the fusion of IGH/Bcl-2 with the prognosis of patients were analyzed. RESULTS The expression of MYC in low IPI group (IPI= 3--5) was higher than that of low IPI score group (IPI= 0-2;χ2= 1.25, P= 0.04). In CD5+ and GCB subgroup,the expression of Bcl-2 was increased (χ2=2.22,P=0.001;χ2=13. 70,P=0. 002) ,but the Bcl-6 was decreased (χ2=5. 58,P=0. 004; χ2=7.26,P=0. 007). Lower expression of MYC,Bcl-2 lead to a higher HR of OS and PFS (P values were 0. 005, 0. 016, 0. 003 and 0. 001), higher expression of Bcl-6 lead to a higher FIR of PFS (P= 0. 035). Low IPI score was also lead to high HR of PFS and OS than that of high IPI score (Both P values were 0. 001). CONCLUSION The expression of MYC,Bcl-2 and Bcl-6 can predict the prognosis of DLBCL,they can be used in the future as prognostic markers for patients with DLBCL.
出处
《中华肿瘤防治杂志》
CAS
北大核心
2015年第15期1193-1197,共5页
Chinese Journal of Cancer Prevention and Treatment