重组人Dickkopf相关蛋白3在弥漫性大B细胞淋巴瘤患者中的表达及其临床意义

Expression of Recombinant Human Dickkopf-associated Protein 3 in Patients with Diffuse Large B-cell Lymphoma and Its Clinical Significance

目的探讨重组人Dickkopf相关蛋白3(DKK3)在弥漫性大B细胞淋巴瘤(DLBCL)患者中的表达及其临床意义。方法纳入2017年12月至2019年12月恩施土家族苗族自治州中心医院收治的DLBCL患者56例,选取DLBCL组织和癌旁组织为检测标本。应用免疫组织化学法检测组织DKK3蛋白表达,并分析其与患者临床特征的关系;记录并比较DLBCL阳性和阴性患者的近期临床疗效和中位无进展生存期。结果免疫组织化学检测结果显示,DLBCL组织中DKK3蛋白阳性表达率明显低于癌旁组织[42.86%(24/56)比83.93%(47/56)](χ^(2)=7.782,P<0.001)。临床分期Ⅰ-Ⅱ期的DKK3阳性表达率高于Ⅲ-Ⅳ期[57.14%(16/28)比28.57%(8/28)],国际预后指数评分0-2分的DKK3阳性表达率高于3-4分[52.78%(19/36)比25.00%(5/20)](P<0.05)。术后1年DKK3阳性表达的DLBCL患者的总有效率明显高于DKK3阴性表达患者[79.17%(19/24)比53.13%(17/32)](χ^(2)=4.051,P=0.044)。至随访结束,DKK3阳性表达的DLBCL患者中位无进展生存期长于DKK3阴性表达患者[(36±6)个月比(22±4)个月](P<0.01)。结论DKK3在DLBCL患者中低表达,与临床分期及国际预后指数评分有关,对预后判断也有积极意义,可作为DLBCL诊断和治疗的潜在靶点。

Objective To investigate the expression of recombinant human Dickkopf-associated protein 3(DKK3)in patients with diffuse large B-cell lymphoma(DLBCL)and its clinical significance.Methods A total of 56 patients with DLBCL admitted to The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture from Dec.2017 to Dec.2019 were included.DLBCL tissues and paracancer tissues removed from the patients were collected as detection specimens.Immunohistochemistry was used to detect the expression of DKK3 protein in the tissues,and the relationship between them and the clinical features was analyzed.Short-term clinical efficacy and median progression-free survival were compared between DLBCL positive and negative patients.Results Immunohistochemical results showed that the positive expression rate of DKK3 protein in DLBCL tissues was significantly lower than that in the paracancer tissues[42.86%(24/56)vs 83.93%(47/56)](χ^(2)=7.782,P<0.001).The positive expression rate of DKK3 in stageⅠ-Ⅱwas higher than that in stageⅢ-Ⅳ[57.14%(16/28)vs 28.57%(8/28)],and the positive expression rate of DKK3 of cases with international prognostic index score of 0-2 was higher than that of 3-4[52.78%(19/36)vs 25.00%(5/20)](P<0.05).The total effective rate of DLBCL patients with positive DKK3 expression was significantly higher than that of patients with negative DKK3 expression[79.17%(19/24)vs 53.13%(17/32)](χ^(2)=4.051,P=0.044).At the end of follow-up,the median progression-free survival of DLBCL patients with DKK3 positive expression was longer than that of DLBCL patients with DKK3 negative expression[(36±6)months vs(22±4)months](P<0.01).Conclusion The low expression of DKK3 in DLBCL patients is related to clinical stage and international prognostic index score,and has positive significance for prognosis,which can be used as a potential target for the diagnosis and treatment of DLBCL.