弥漫大B细胞淋巴瘤中细胞分裂周期蛋白6的表达及其临床意义

Expression and clinical significance of CDC6 in diffuse large B-cell lymphoma

目的探讨细胞分裂周期蛋白6(CDC6)在弥漫大B细胞淋巴瘤(DLBCL)中的表达及其预后意义。方法选择原发DLBCL患者60例为研究组,同期取20例淋巴结反应性增生组织的患者为对照组。采用免疫组化检测并比较两组CDC6蛋白表达水平,进而分析CDC6蛋白与DLBCL临床病理特征及预后的关系。结果研究组CDC6蛋白阳性率(56.67%)高于对照组(25.00%),差异有统计学意义(χ^(2)=6.02,P<0.05);在DLBCL组织中,非生发中心型B细胞样(non-GCB)亚型患者CDC6蛋白阳性率(71.05%)明显高于生发中心型B细胞样(GCB)亚型(31.82%),差异有统计学意义(χ^(2)=8.74,P<0.05);进一步分析预后结果显示,GCB亚型的总生存期(OS)和无进展生存时间(PFS)长于non-GCB亚型,差异均有统计学意义(χ^(2)分别=13.16、12.39,P均<0.05);联合利妥昔单抗方案化疗患者的OS和PFS均长于未联合利妥昔单抗方案化疗患者,差异均有统计学意义(χ^(2)分别=4.18、4.72,P均<0.05),CDC6蛋白阳性表达患者的OS和PFS短于CDC6蛋白阴性表达患者,差异均有统计学意义(χ^(2)分别=6.96、7.25,P均<0.05)。结论CDC6蛋白在DLBCL中的表达高于淋巴结反应性增生组织,CDC6蛋白在non-GCB亚型中的表达高于GCB亚型;CDC6蛋白阳性的DLBCL患者可能预后不良。

Objective To investigate the expression and prognostic significance of cell division cyclin 6(CDC6)in dif-fuse large B-cell lymphoma(DLBCL).Methods Sixty patients with primary DLBCL were selected as the study group and 20 patients with reactive lymph node hyperplasia as the control group during the same period.Immunohistochemistry was performed and the expression levels of CDC6 were compared between the two groups.The relationship between CDC6 pro-tein and the clinicopathologic characteristics and prognosis of lymphoma was analyzed.Results The rate of CDC6 protein positivity was higher in the study group(56.67%)than in the control group(25.00%),with statistical significance(χ^(2)=6.02,P<0.05).In DLBCL tissue,the percentage of positive CDC6 in patients with non-GCB subtype(71.05%)was significantly higher than that of GCB subtype(31.82%),with statistical significance(χ^(2)=8.74,P<0.05).Further analysis of the prognosis showed that the OS and PFS of the GCB subtype were longer than those of the non-GCB subtype,and the differences were statistically significant(χ^(2)=13.16,12.39,P<0.05).Both OS and PFS were longer with rituximab than without rituximab che-motherapy(χ^(2)=4.18,4.72,P<0.05).OS and PFS were shorter in patients with positive expression of CDC6 protein than in patients with negative expression of CDC6 protein(χ^(2)=6.96,7.25,P<0.05).Conclusion The expression of CDC6 protein is higher in DLBCL than in lymph node-reactive proliferating tissue,the expression of CDC6 protein is higher in the non GCB subtype than in the GCB subtype,and patients with CDC6 protein-positive DLBCL may have a poor prognosis.