p53和c-Myc表达对弥漫大B细胞淋巴瘤相关噬血细胞综合征的预后影响

Prognostic effect of p53 and c-Myc expression in diffuse large B cell lymphomaassociated hemophagocytic syndrome

目的探讨p53和c-Myc表达对弥漫大B细胞淋巴瘤(diffuse large B cell lymphoma,DLBCL)相关噬血细胞综合征患者的预后影响。方法回顾性分析2018年1月至2021年1月浙江大学医学院附属第一医院、台州市第一人民医院确诊的30例成人DLBCL相关噬血细胞综合征患者的临床资料,采用免疫组织化学法检测p53、c-Myc表达,结合临床资料进行预后影响因素分析。结果p53和c-Myc均阳性表达占43.3%(13/30),p53和(或)c-Myc阴性表达占56.7%(17/30)。p53和c-Myc阳性组患者的纤维蛋白原显著低于p53和(或)c-Myc阴性组,血清铁蛋白、白细胞介素-10均显著高于p53和(或)c-Myc阴性组(P<0.05)。p53和c-Myc阳性组患者的12个月总生存率显著低于p53和(或)c-Myc阴性组(23.1%vs.82.4%,P<0.05)。结论免疫组织化学法检测p53、c-Myc表达能够预测DLBCL相关噬血细胞综合征患者的预后,p53和c-Myc均阳性表达的患者预后较差。

Objective To investigate the effect of p53 and c-Myc expression on prognosis of patients with diffuse large B cell lymphoma(DLBCL)associated hemophagocytic syndrome.Methods The clinical data of 30 adult patients with DLBCL-associated hemophagocytic syndrome diagnosed in the First Affiliated Hospital,Zhejiang University School of Medicine and the First People’s Hospital of Taizhou from January 2018 to January 2021 were retrospectively analyzed.The expression of p53 and c-Myc was detected by immunohistochemistry,and the prognostic factors were analyzed in combination with clinical data.Results Both p53 and c-Myc were positive in 43.3%(13/30),and p53 and(or)c-Myc were negative in 56.7%(17/30).The fibrinogen of p53 and c-Myc positive group was significantly lower than that of p53 and(or)c-Myc negative group,and serum ferritin and interleukin-10 were significantly higher than those of p53 and(or)c-Myc negative group(P<0.05).The 12-month overall survival rate in p53 and c-Myc positive group was significantly lower than that in p53 and(or)c-Myc negative group(23.1%vs.82.4%,P<0.05).Conclusion Immunohistochemical detection of p53 and c-Myc expression can predict the prognosis of patients with DLBCL-associated hemophagocytic syndrome,and patients with positive expression of both p53 and c-Myc have poor prognosis.