C-myc蛋白表达与获得性免疫缺陷综合征相关弥漫大B细胞淋巴瘤预后相关性研究

Correlation between C-myc Protein Expression and Prognosis of AIDS- related Diffuse Large B-cell Lymphoma

目的 探讨C-myc蛋白表达与获得性免疫缺陷综合征(AIDS)相关弥漫大B细胞淋巴瘤预后的相关性。方法 选取2018年2月—2020年4月收治的100例AIDS相关弥漫大B细胞淋巴瘤作为研究对象。纳入对象采用免疫组织化学检查检测肿瘤组织石蜡切片中C-myc蛋白表达水平,并分为阴性表达组(C-myc<40%)、阳性表达组(C-myc≥40%),随后分析C-myc蛋白表达与AIDS相关弥漫大B细胞淋巴瘤患者临床病理特征、预后的关系。结果 AIDS相关弥漫大B细胞淋巴瘤患者C-myc蛋白表达与临床分期、国际预后指数(IPI)评分存在显著相关性,Ⅲ~Ⅳ期、IPI评分≥3分患者C-myc蛋白阳性表达率高于Ⅰ~Ⅱ期、IPI评分<3分患者(P<0.01)。C-myc蛋白阳性表达组、阴性表达组3年生存率分别为36.84%(14/38)、83.87%(52/62),2组3年生存率比较差异有统计学意义(P<0.01)。多因素Cox回归分析显示,临床分期Ⅲ~Ⅳ期、IPI评分≥3分、C-myc蛋白阳性表达均是AIDS相关弥漫大B细胞淋巴瘤患者预后的独立危险因素(P<0.01)。结论 随着AIDS相关弥漫大B细胞淋巴瘤病情进展,C-myc蛋白表达水平逐渐升高,其表达水平与患者生存期有一定相关性,有望成为评估患者预后的生物标志物。

Objective To investigate the correlation between C-myc protein expression and prognosis of acquired immune deficiency syndrome(AIDS)-related diffuse large B-cell lymphoma(DLBCL).Methods In total,100 patients with AIDS-related DLBCL treated from February 2018 to April 2020 were selected as the research subjects.The C-myc protein expression level in paraffin sections of tumor tissues was detected by immunohistochemistry and divided into negative expression group(C-myc<40%)and positive expression group(C-myc≥40%).The relationship between C-myc protein expression and clinical opathologial features and prognosis of patients with AIDS-related DLBCL was analyzed.Results C-myc protein expression was significantly correlated with clinical stage and international prognostic index(IPI)score in patients with AIDS-related DLBCL.The positive expression rate of C-myc protein in patients with stageⅢtoⅣand IPI score≥3 was higher than that in patients with stageⅠtoⅡand IPI score<3(P<0.01).The 3-year survival rates of the positive expression group and the negative expression group were 36.84%(14/38)and 83.87%(52/62),respectively,and there was significant difference in 3-year survival rates between the two groups(P<0.01).Multivariate Cox regression analysis showed that clinical stageⅢtoⅣ,IPI score≥3 and positive expression of C-myc protein were independent risk factors for the prognosis of AIDS-related DLBCL(P<0.01).Conclusion With the progression of AIDS-related DLBCL,C-myc protein expression is gradually increased,and its expression level is correlated with the survival of patients,which is expected to be a biomarker to evaluate the prognosis of patients.