肿瘤细胞周期相关蛋白在肾移植术后弥漫大B细胞淋巴瘤中的表达及与预后的关系

Expression of tumor cell cycle-related proteins in diffuse large B-cell lymphoma after renal transplantation and its relationship with prognosis

目的 探讨肿瘤细胞周期相关蛋白(CREPT)在肾移植术后弥漫大B细胞淋巴瘤(DLBCL)中的表达及与预后的关系研究。方法 选择2013年2月至2019年8月海南医学院第一附属医院、海南省肿瘤医院、海南医学院第二附属医院收治的40例肾移植术后发生DLBCL的病人作为研究对象,以病灶组织作为病例组;另外选择50例增生性淋巴结炎组织作为对照组。采用免疫组化方法检测组织CREPT表达情况,收集肾移植术后DLBCL病人的临床资料,分析临床资料、治疗效果、预后与CREPT表达的关系。结果 CREPT定位于细胞核或细胞质,40例肾移植术后发生DLBCL病人中CREPT高表达者23例(57.50%),50例增生性淋巴结炎组织中高表达者5例(10.00%)(P<0.05)。CREPT高表达组EB活化率高于低表达组,高Ann Arboe分期病人比例高于CREPT低表达组(P<0.05)。达到有效标准病人36例,多因素分析示,Ann Arboe分期是治疗效果的影响因素(P<0.05)。CREPT高表达组病人总生存期显著低于低表达组(P<0.05);两组无进展生存期比较差异无统计学意义(P>0.05);Cox多因素分析,Ann Arboe分期、治疗应答情况与无进展生存期回归相关(P<0.05);移植肾功能降低、Ann Arboe分期、体能评分(ECOG)、治疗应答情况、CREPT表达情况与总生存期相关(P<0.05)。结论 肾移植术后DLBCL病人CREPT表达水平较高,且与病人临床特征、预后存在一定关系。

Objective To investigate the expression of tumor cell cycle-related proteins(CREPTs) in diffuse large B-cell lymphoma(DLBCL) after renal transplantation and the relationship with prognosis.Methods Forty patients who developed DLBCL after kidney transplantation admitted to the First Affiliated Hospital of Hainan Medical College,Hainan Cancer Hospital and the Second Affiliated Hospital of Hainan Medical College from February 2013 to August 2019 were selected as the study subjects,and the lesion tissues were used as the case group.In addition,50 cases of hyperplastic lymphadenitis tissues were selected as the control group.The expression of CREPT was detected by immunohistochemical method,and clinical data of DLBCL patients after renal transplantation were collected to analyze the relationship between clinical data,treatment effect,prognosis and CREPT expression.Results CREPT was localized in the nucleus or cytoplasm of cells.Twenty-three of 40 patients(57.50%) with DLBCL after renal transplantation and 5 of 50 patients(10.00%) with hyperplastic lymphadenitis tissues had high expression of CREPT(P<0.05).The rate of EB activation was higher in the group with high CREPT expression than that in the group with low expression,and the proportion of patients with high Ann Arboe stage was higher than in the group with low CREPT expression(P<0.05).There were 36 patients who met the effective criteria.Multivariate analysis showed that Ann Arboe stage was an influential factor in treatment outcome(P<0.05).The overall survival time was significantly lower in the group with high CREPT expression than in the group with low expression(P<0.05);the difference in progression-free survival between the two groups was not statistically significant(P>0.05).The Cox multivariate analysis showed that Ann Arboe stage and treatment response were associated with progression-free survival regression(P<0.05).Reduced transplant renal function,Ann Arboe stage,physical performance score(ECOG),treatment response,and CREPT expression were correlated with overall survival(P<0.05).Conclusion The expression level of CREPT was higher in DLBCL patients after renal transplantation and was associated with the clinical characteristics and prognosis of the patients.