弥漫大B细胞淋巴瘤中STAT5A的表达及意义

Expression of STAT5A in diffuse large B cell lymphoma and its significance

目的探讨信号转导与转录激活因子5A(signal transducer and activator of transcription 5A,STAT5A)在弥漫大B细胞淋巴瘤(diffuse large B cell lymphoma,DLBCL)中的表达及临床意义。方法采用免疫组化法检测106例DLBCL中STAT5及磷酸化STAT5A^(Tyr694)(pSTAT5A^(Y694))的表达,分析STAT5核表达水平及pSTAT5A^(Y694)表达水平与DLBCL临床病理特征及预后的相关性。结果STAT5核表达与骨髓浸润(P=0.004)、治疗反应(P=0.001)相关,其在有骨髓浸润、疾病进展/稳定患者中的表达高于无骨髓浸润、部分缓解(partial response,PR)/完全缓解(complete response,CR)患者。pSTAT5A^(Y694)表达水平与Ki-67增殖指数(P=0.022)、治疗反应(P=0.003)相关,其在Ki-67增殖指数≥75%、疾病进展/稳定患者中的表达高于Ki-67增殖指数<75%、PR/CR患者。STAT5核表达以及pSTAT5A^(Y694)表达水平与其它临床病理特征均无关(P均>0.05)。Kaplan-Meier生存分析显示:STAT5核阳性DLBCL患者的总生存期(overall survival,OS)低于阴性患者(P=0.0117);且pSTAT5A^(Y694)阳性患者的OS低于阴性患者(P=0.0102)。单因素和多因素Cox回归分析显示:STAT5核表达水平(P=0.243)、pSTAT5A^(Y694)表达水平(P=0.093)是影响OS的相关因素,但不是预后的独立影响因素。结论STAT5核表达以及pSTAT5A^(Y694)表达与DLBCL患者的治疗反应相关。STAT5核阳性、pSTAT5A^(Y694)阳性DLBCL患者的OS比阴性患者缩短;STAT5核表达水平、pSTAT5A^(Y694)表达水平是影响OS的相关因素,但不是预后的独立影响因素。

Purpose To investigate the expression and clinical significance of signal transducer and activator of transcription 5A(STAT5A)in newly-diagnosed diffuse large B cell lymphoma(DLBCL).Methods Immunohistochemistry was used to evaluate STAT5 and phospho-STAT5A^(Tyr694)(pSTAT5A^(Y694))expression in 106 cases of DLBCL patients.The correlation between nuclear STAT5 expression,pSTAT5A^(Y694) expression and clinicopathological characteristics and prognosis was also analyzed.Results Nuclear STAT5 expression was correlated with bone marrow infiltration(P=0.004)and treatment response(P=0.001).Nuclear STAT5 expression was higher in patients with bone marrow infiltration,progressive stable disease(PD)/disease(SD)than patients without bone marrow infiltration and patients with partial response(PR)/complete response(CR).pSTAT5A^(Y694) expression was correlated with Ki-67 index(P=0.022)and treatment response(P=0.003).pSTAT5A^(Y694) expression was higher in patients with Ki-67 index≥75%and PD/SD than patients with Ki-67 index<75%and PR/CR.However,nuclear STAT5 and pSTAT5A^(Y694) expression was not correlated to other clinicopathological parameters(all P>0.05).Kaplan-Meier survival analysis showed that patients with nuclear STAT5 expression had shortened overall survival(OS)compared with those with negative nuclear STAT5 expression(P=0.0117).Similarly,patients with pSTAT5A^(Y694) expression had shortened OS compared with those with negative pSTAT5A^(Y694) expression(P=0.0102).Univariate and multivariate regression analysis showed that nuclear STAT5(P=0.243)and pSTAT5A^(Y694)(P=0.093)were factors affecting OS,but not independent prognostic factors.Conclusion Nuclear STAT5 expression and pSTAT5A^(Y694) expression are correlated with treatment response in DLBCL.Patients with nuclear STAT5/pSTAT5A^(Y694) expression have shortened OS compared with those with negative nuclear STAT5/pSTAT5A^(Y694) expression.Nuclear STAT5 and pSTAT5A^(Y694) are factors affecting OS,but not independent prognostic factors.