转录因子T-bet在外周T细胞淋巴瘤患者中的表达及其预后意义初探

T-bet in peripheral T-cell lymphoma

目的观察转录因子T-bet（T-boxexpressedinTcells）在外周T细胞淋巴瘤（PTCL）患者中的表达并分析其与预后的相关性。方法收集2007年至2013年间由北京协和医院病理科诊断的109例初治PTCL患者的石蜡包埋病理标本及临床资料。对患者标本进行免疫组化染色，观察转录因子T-bet的表达并分析其与患者临床特征及预后的关系。结果109例初治PTCL患者中PTCL非特指型（PTCL-NOS）60例，NK．T细胞淋巴瘤（NKT）18例，血管免疫母细胞性T细胞淋巴瘤11例，ALK阳性及阴性间变大细胞淋巴瘤各4例，其他12例。109例患者中T-bet总体阳性率为42．2％，在PTCL-NOS组患者中为43．3％，在NKT组患者中为44．4％。Kaplan-Meier生存曲线法结果显示，T-bet表达水平与PTCL患者总生存期无相关性（P=0．586）。病理亚型分层研究发现，T-bet表达水平与PTCL．NOS组患者总生存期无相关性（P=0．309），与NKT组患者总生存期呈正相关（P：0．004）。多因素分析提示ECOG评分≥2分为影响PTCL患者预后的独立危险因素（HR=5．907，95％CI2．399～14．549，P〈0．001）。结论转录因子T-bet在几类PTCL病理亚型患者中均有阳性表达，其表达水平与NKT患者总生存期呈正相关。

Objective To evaluate the expression of transcription factor T-bet （T-box expressed in T cells） and explore its effects on prognosis in peripheral T-cell lymphoma （PTCL）. Methods This study included 109 previously untreated patients diagnosed with PTCL in the pathology system at Peking Union Medical College Hospital from 2007 to 2013. Formalin-fixed, paraffin-embedded blocks and clinical information of these patients were collected. T-bet expression was examined by immunohistochemical stain, while its relationship with clinical feature and prognosis was analyzed. Results 109 PTCL patients included 60 PTCL-not other specified （PTCL-NOS） cases and 18 NK/T-cell lymphoma. The positive rate of T-bet was 42.2% overall, 43.3% in PTCL-NOS and 44.4% in NK/T lymphoma. T-bet high expression wasn＇t correlated with OS in PTCL patients （P=-0.586） by Kaplan-Meier analysis. Further stratification by pathological subgroup implied a correlation of T-bet high expression with better survival in NK/T lymphoma （P=-0.004）, but not in PTCL-NOS （P=0.309）. Multivariate analysis confirmed that high ECOG score （≥2） was an independent predictor of overall survival （HR=5.907, 95%CI 2.399-14.549, P〈0.001 ）. Conclusion T-bet was detected in several PTCL subgroups with diversities, which is positively correlated with overall survival in NK/T-cell lymphoma.