B细胞淋巴瘤/白血病-2基因、CD10和细胞周期蛋白D1在B细胞性非霍奇金淋巴瘤组织中的表达及意义

Expression and significance of B-cell lymphoma/leukemia-2 gene, CD10 and cyclin D1 in B-cell non-Hodgkin′s lymphoma

目的探讨B细胞淋巴瘤/白血病-2基因(Bcl-2)、CD10和细胞周期蛋白D1(cyclin D1)在B细胞性非霍奇金淋巴瘤(B-NHL)组织中的表达及临床意义。方法选择2017年6月至2019年8月新乡医学院第一附属医院收治的78例B-NHL患者(B-NHL组)和50例淋巴组织反应性增生患者(对照组)为研究对象。取B-NHL组患者肿瘤组织和对照组患者反应性增生淋巴组织,采用免疫组织化学染色法检测Bcl-2、CD10及cyclin D1表达,比较2组患者Bcl-2、CD10及cyclin D1表达情况;收集B-NHL患者临床病历资料,分析Bcl-2、CD10和cyclin D1水平与B-NHL临床病理特征的关系;对B-NHL患者随访1 a,统计患者病死情况,采用单因素分析和logistic回归分析影响预后的因素。结果 B-NHL组患者Bcl-2、CD10及cyclin D1阳性表达率分别为78.21%(61/78)、38.46%(30/78)、87.18%(68/78),对照组患者Bcl-2、CD10及cyclin D1阳性表达率分别为36.00%(18/50)、100.00%(50/50)、0.00%(0/50);B-NHL组患者Bcl-2、cyclin D1阳性表达率显著高于对照组(χ^(2)=22.971、92.992,P<0.01),CD10阳性表达率显著低于对照组(χ^(2)=49.231,P<0.01)。B-NHL患者的年龄、性别、肿瘤直径、肿瘤位置、临床分期与Bcl-2、CD10及cyclin D1阳性表达无关(P>0.05);B-NHL患者的病理类型与CD10、cyclin D1阳性表达相关(P<0.05),与Bcl-2阳性表达无关(P>0.05)。B-NHL组患者病死20例(25.64%),生存58例(74.36%);肿瘤临床分期、病理类型、Bcl-2、CD10及cyclin D1表达与B-NHL患者病死相关(P<0.05),年龄、性别、肿瘤直径、肿瘤位置与B-NHL患者病死无关(P>0.05)。Logistic回归分析结果显示,临床分期Ⅲ~Ⅳ期、病理类型为弥漫大B细胞淋巴瘤、Bcl-2阳性表达、cyclin D1阳性表达及CD10阴性表达是影响B-NHL患者死亡的独立危险因素(P<0.01)。结论 Bcl-2、CD10及cyclin D1在B-NHL组织中异常表达,其可能参与了B-NHL的发生、发展;CD10、cyclin D1检测可鉴别诊断不同病理类型的B-NHL,且可作为评估B-NHL患者预后的参考指标。

Objective To investigate the expression and clinical significance of B-cell lymphoma/leukemia-2 gene(Bcl-2),CD10 and cyclin D1 in B-cell non-Hodgkin′s lymphoma(B-NHL).Methods A total of 78 B-NHL patients(B-NHL group) and 50 patients with reactive hyperplastic lymphoid tissue(control group) admitted to the First Affiliated Hospital of Xinxiang Medical University from June 2017 to August 2019 were selected as the study subjects.The expressions of Bcl-2,CD10 and cyclin D1 in tumor tissues of patients in the B-NHL group and reactive hyperplasia lymphoid tissues of patients in the control group were detected by immunohistochemical staining, and the expressions of Bcl-2,CD10 and cyclin D1 of patients were compared between the two groups.The clinical data of B-NHL patients were collected, and the relationships between the levels of Bcl-2,CD10,cyclin D1 and the clinical characteristics of B-NHL were analyzed.Patients with B-NHL were followed up for one year, and the death of patients was counted.Univariate analysis and logistic regression analysis were used to analyze the prognostic factors.Results The positive expression rates of Bcl-2,CD10 and cyclin D1 of patients in the B-NHL group were 78.21%(61/78),38.46%(30/78) and 87.18%(68/78),respectively.The positive expression rates of Bcl-2,CD10 and cyclin D1 of patients in the control group were 36.00%(18/50),100.00%(50/50) and 0.00%(0/50),respectively.The positive expression rates of Bcl-2 and cyclin D1 of patients in the B-NHL group were significantly higher than those in control group(χ^(2)=22.971,92.992;P<0.01),and the positive expression rate of CD10 was significantly lower than that in the control group(χ^(2)=49.231,P<0.01).The age, gender, tumor diameter, tumor location, clinical stage were not related to the positive expression of Bcl-2,CD10 and cyclin D1 in B-NHL group(P>0.05);the pathological type was correlated with positive expression of CD10 and cyclin D1 in B-NHL patients(P<0.05),while the pathological type was not correlated with positive expression of Bcl-2(P>0.05).In B-NHL group, 20(25.64%) patients died and 58(74.36%) patients survived.The clinical stage, pathological type, expression of Bcl-2,CD10 and cyclin D1 were correlated with death of patients with B-NHL(P<0.05),while age, gender, tumor diameter and tumor location were not correlated with death of patients with B-NHL(P>0.05).Logistic regression analysis showed that the clinical stage Ⅲ-Ⅳ,the pathological type of diffuse large B cell lymphoma, Bcl-2 positive expression, cyclin D1 positive expression and CD10 negative expression were independent risk factors affecting the death of B-NHL patients(P<0.01).Conclusions The expression of Bcl-2,CD10 and cyclin D1 in B-NHL tissues are abnormal, which may participate in the occurrence and development of B-NHL.The detection of CD10 and cyclin D1 can diagnose the different pathological types of B-NHL,and can be used as reference indexto evaluate the prognosis of B-NHL patients.