血清淀粉样蛋白A联合错误折叠的转甲状腺素蛋白对复发/难治弥漫大B细胞淋巴瘤患者的临床价值

Clinical Value of Serum Amyloid A and Misfolded Transthyretin for Relapsed/Refractory Diffuse Large B-Cell Lymphoma Patients

目的:探讨血清淀粉样蛋白A(SAA)和错误折叠的转甲状腺素蛋白(TTR)对复发/难治弥漫性大B细胞淋巴瘤(R/R DLBCL)患者的临床价值。方法:选取R/R DLBCL患者30例作为研究组,缓解/稳定DLBCL患者20例及慢性淋巴结炎患者10例作为对照组,应用SELDI技术、Tris-Tricine十二烷基硫酸钠-聚丙烯酰氨凝胶电泳(Tris-Tricine-SDS-PAGE)技术、shotgun串联质谱混合蛋白质鉴定技术(shotgun-LTQ-MS)和生物信息学技术对鉴定蛋白质进行分析,发现R/R DLBCL血清中存在SAA和TTR蛋白。采用SPSS 21.0统计软件分析血清中高表达SAA及错误折叠TTR与R/R DLBCL患者临床病理特征、生存期的关系。卡方检验分析临床计数资料,Kaplan-Meier曲线进行生存分析,Log-Rank检验比较单因素生存差异。结果:SAA和TTR(SAA+TTR+)同时高表达与R/R DLBCL患者结外病变、高水平LDH和NCCN-IPI评分显著相关,与non-GCB分型相关。TTR+与病理组织中的CMYC蛋白相关,而SAA+与B症状相关。SAA+组、TTR+组及SAA+TTR+组患者较阴性组生存期缩短,统计分析有显著差异。结论:SAA和错误折叠的TTR均为R/R DLBCL预后不良因素。

Objective:To evaluate the clinical value of serum amyloid A(SAA1/2)and misfolded transthyretin(TTR)for relapsed/refractory diffuse large B-cell lymphoma(R/R DLBCL)patients.Methods:30 R/R DLBCL patients were enrolled as observation group,20 remission/stabilization DLBCL and 10 chronic lymphadenitis patients were enrolled as control group.SELDI technique,Tris-Tricine sodium dodecyl sulfate-polyacrylamide gel electrophoresis,the shotgun-LTQ-MS method,and bioinformatics technique were used to detected and analyzed SAA and TTR in R/R DLBCL patients.SPSS 21.0 software was used to analyze the relationship between the high expression of SAA,misfolded TTR in serum and the clinicopathological features,survival time of R/R DLBCL.patients Chi-square test was used to analyze clinical count data,Kaplan-Meier curve was used for survival analysis,and Log-Rank test was used to compare single-factor survival differences.Results:The high expression of SAA and TTR(SAA+TTR+)was significantly associated with extranodal lesion,high level of LDH,and NCCN-IPI scores,and also correlated with non-GCB type.TTR+was correlated with C-MYC in pathological tissue,while SAA+was also associated with Bsymptoms.The survival time of patients in SAA+,TTR+,and SAA+TTR+group were shorter than that in control group.Conclusion:Both SAA and misfolded TTR are poor prognosis factors of R/R DLBCL patients.