Bcl-2、C-myc蛋白的表达与弥漫性大B细胞淋巴瘤预后的研究

Prognostic significance of BCL-2 and C-MYC protein expression in diffuse large B cell lymphoma

目的探讨Bcl-2、C-myc蛋白表达在弥漫性大B细胞淋巴瘤(DLBCL)诊断、预后判断及治疗中的价值。方法采用免疫组织化学染色法检测72例DLBCL组织标本中C-myc、Bcl-2、CD10、Bcl-6、MUM-1蛋白的表达情况。结果卡方检验统计分析:bcl-2在患者的临床分期、IPI评分及病理分型之间表达有显著差异(P<0.05);C-myc在患者的临床分期及IPI评分之间的表达有显著差异(P<0.05);bcl-2和C-myc蛋白共表达和非共表达在患者的临床分期、B症状及IPI评分之间有显著差异(P<0.05)。②Kaplan-Meier法单因素分析:患者的年龄、临床分期、B症状、IPI评分、病理分型、bcl-2蛋白表达及bcl-2/C-myc共表达与患者的平均OS及平均PFS比较有统计学意义(P<0.05)。患者的性别、原发部位、C-myc蛋白表达的平均OS和平均PFS比较无统计学意义(P> 0.05)。③COX多因素分析:DLBCL患者的年龄、临床分期、B症状和bcl-2蛋白与OS之间的分析有统计学意义(P<0.05);DLBCL患者的年龄、临床分期、B症状与PFS之间的分析有统计学意义(P<0.05)。结论 DLBCL患者的年龄、临床分期、有无B症状、IPI评分、病理分型和bcl-2蛋白可以初步判断预后,对指导临床治疗有一定意义;患者的年龄、临床分期、B症状和Bcl-2蛋白的表达是影响DLBCL患者预后的独立危险因素;C-myc的单独表达尚不能作为影响DLBCL患者预后的独立危险因素。

Objective To investigate the value of Bcl-2 and C-MYC protein expression and co-expression in the diagnosis,prognosis and treatment of diffuse large B cell lymphoma(DLBCL).Methods Immunohistochemical staining was used to detect the expression of C-MYC,Bcl-2,CD10,Bcl-6 and MUM-1 protein in 72 cases of DLBCL collected in the First People’s Hospital of Chenzhou.Results Chi-square test analysis showed that there were significant differences in the expression of bcl-2 pstients between the clinical staging,IPI score and pathological typing(P<0.05).There was a significant difference in the expression of C-MYC between the clinical stage and IPI score of the patients(P<0.05);There were significant differences in patients’ clinical staging,symptom B and IPI score between BCL-2 and C-MYC protein coexpression and non-co-expression(P < 0.05).Kaplan-Meier single factor analysis showed that there were significant differences between patients age,clinical stage,B symptoms,IPI score,GCB,the BCL-2 protein positive,Bcl-2/C-MYC and average OS and PFS(P < 0.05).COX multivariate analysis showed that DLBCL patients’ age,clinical stage,B symptoms,Bcl-2 and OS were statistically significant(P < 0.05).The difference between DLBCL patient’age,clinical stag,B symptom and PFS was statistically significant(P < 0.05).Conclusion DLBCL patients’ age,clinical stage,presence or absence of symptoms B,IPI score,pathological classification and BCL-2 can preliminarily determine the prognosis,which is of certain significance for guiding clinical treatment.Patients’ age,clinical stage,B symptom and Bcl-2 expression are the independent risk factors affecting the prognosis of patients with DLBCL.Age,clinical stage,and B symptom are independent risk factors for judging patient’s condition.The single expression of C-myc cannot be considered as an independent risk factor affecting the prognosis of patients with DLBCL.