T-LBL/ALL患者病变组织CD分子、MPO、Ki-67和C-MYC阳性比例及C-MYC基因在预测预后中的价值  

Value of CD,MPO,Ki-67 and C-MYC Positive Rate in the Pathological Tissues and C-MYC Gene of Patients with T-LBL/ALL for Predicting Prognosis

作　　者：吴洋 唐红艳[2] 丁异熠[2] 潘晓琴[2] 谭传梅[2] 

机构地区：[1]甘肃省人民医院血液科,甘肃兰州730000 [2]常德市第一人民医院儿科,湖南常德415003

出　　处：《中国实验血液学杂志》2018年第1期110-115,共6页Journal of Experimental Hematology

摘　　要：目的:探讨T-LBL/ALL患者病变组织CD分子、MPO、Ki-67和C-MYC阳性比例及C-MYC在预测预后中的价值。方法:选取本院收治的T-LBL/ALL患者90例为T-LBL/ALL组及30例淋巴结反应性增生作为对照组。对2组患者进行免疫组织化学染色检测CD分子、MPO、Ki-67和C-MYC阳性比例及应用荧光原位杂交检测C-MYC基因的改变情况。结果:在90例T-LBL/ALL患者中,CD1a^+34例(37.8%),CD3·+67例(74.4%),εCD3^+47例(52.2%),CD7^+85例(94.4%),CD10^+33例(36.7%),CD34^+22例(24.4%),CD43^+48例(53.3%),CD45RO^+46例(51.1%),CD99^+88例(97.8%),TDT^+85例(94.4%),CD23、CD20、MPO均为阴性,Ki-67>80%47例(52.2%),Ki-67≤80%43例(47.8%)。在T-LBL/ALL组90例患者中,C-M YC蛋白阳性率为66.7%,明显高于对照组(阳性率为0)(P<0.05);C-MYC阳性率与T-LBL/ALL患者的Ki-67阳性指数、纵膈增宽呈正相关(r=0.567,r=0.532,P<0.05)。C-MYC蛋白阴性患者的1年总生存率(44.0%)明显高于C-MYC蛋白阳性患者(15.0%),C-MYC蛋白阴性患者总体生存率明显高于C-MYC阳性患者(P<0.05)。T-LBL/ALL患者的Ann Arbor分期、LDH、骨髓累及、纵膈增宽、Ki-67阳性指数、C-M YC蛋白表达与C-MYC基因断裂及拷贝数增加均无相关性(P>0.05)。结论:C-MYC蛋白阳性的患者总体生存率降低,与Ki-67阳性指数、纵膈增宽呈正相关,提示C-MYC蛋白表达的患者预后较差。Objective： To explore the value of of CD,MPO,Ki-67,C-MYC positive rates in the pathological tissues and C-MYC gene of patients with T-LBL/ALL for predicting Prognosis. Methods： Ninty cases of T-LBL/ALL patients in our hospital were selected and included in the T-LBL/ALL group,and 30 cases of lymphnode reactive hyperplasia were selected as control group. Immunohistochemical staining was used to detect the changes of CD,MPO,Ki-67 and C-MYC positive rate in 2 groups,and the changes of C-MYC gene were detected by fluorescence in situ hybridization. Results： In 90 patients with T-LBL/ALL,there were CD1 a^＋34 cases（ 37. 8%）,CD3^＋67 cases（ 74. 4%）,epsilon CD3^＋47 cases（ 52. 2%）,CD7^＋85 cases（ 94. 4%）,CD10^＋33 cases（ 36. 7%）,CD34^＋22 cases（ 24. 4%）,CD43^＋48 cases（ 53. 3%）,CD45 RO^＋46 cases（ 51. 1%）,CD99^＋88 cases（ 97. 8%）,TDT^＋85 cases（ 94. 4%）; and CD23,CD20,and MPO all were negative; Ki-67〉 80% 47 cases（ 52. 2% cases）,Ki-67≤80%,43 cases（ 47. 8%）. In 90 T-LBL/ALL patients,the positive rate of C-MYC（ 66. 7%） was significantly higher than the control group（ positive rate 0. 0%）（ P〈0. 05）; the Ki-67 index,mediastinal widening of T-LBL/ALL patients and the positive rate of C-MYC positively were correlated（ P〈0. 05）. The overall survival rate（ 44. 0%） of C-MYC negative patients was significantly higher than that of C-MYC positive patients（ 0. 0%）. The overall survival rate of CMYC negative patients was significantly higher than that of C-MYC positive patients（ P〈0. 05）. Ann Arbor staging,LDH,bone marrowinvolvement,mediastinal widening,Ki-67 positive index,and C-MYC protein expression of patients with T-LBL/ALL did not correlated with increased C-MYC gene breakage and copy number（ P〈0. 05）. Conclusion：The overall survival rate of C-MYC positive patients decreases,which positively correlates with Ki-67 positive index and mediastinal width,suggesting that the prognosis of the patients with C-MYC protein expres

关 键 词：T淋巴母细胞淋巴瘤/白血病 CD MPO KI-67 C-MYC基因 C-MYC蛋白 预测预后 

分 类 号：R733.1[医药卫生—肿瘤] R733.7[医药卫生—临床医学]