Bcl-2、PIM1、P53基因异常在弥漫大B细胞淋巴瘤中的预后价值  

Prognostic Value of Bcl-2,PIM1 and P53 Gene Abnormalities in Diffuse Large B-cell Lymphoma

作　　者：胡杰[1] 刘素娜 李斌[1] 喻镁佳[1] 陈琪[1] HU Jie;LIU Su-na;LI Bin;YU Mei-jia;CHEN Qi(Department of Hematology,the second people's Hospital of Yunnan Province,Kunming,Yunnan,650000,China)

机构地区：[1]云南省第二人民医院血液科,云南昆明650000

出　　处：《现代生物医学进展》2020年第11期2179-2183,共5页Progress in Modern Biomedicine

基　　金：云南省科技厅-昆明医科大学应用基础研究联合基金项目(2018FE001(-266))。

摘　　要：目的:探讨B淋巴细胞瘤-2基因(Bcl-2)、PIM1及P53基因异常在弥漫大B细胞淋巴瘤(DLBCL)中的预后价值。方法:选取在2010年3月~2014年3月期间我院收治的DLBCL患者86例进行研究。采用间期荧光原位杂交检测Bcl-2、PIM1、P53基因。对患者进行为其5年的随访,采用Logistic多因素回归分析Bcl-2、PIM1、P53基因异常与预后的关系。结果:在86例患者中,29例(33.72%)患者存在P53基因缺失;27例(31.39%)患者发生Bcl-2基因多拷贝,3例(3.49%)患者发生Bcl-2基因易位;26例(23.26%)患者发生PIMI基因重排。各基因异常患者在性别、发病年龄、侵犯部位、LDH水平及β2-MG水平上比较,差异均无统计学意义(P>0.05);但是各基因异常患者Ⅲ~Ⅳ期的比例显著高于Ⅰ~Ⅱ期,差异具有统计学意义(P<0.05)。各基因异常组患者的无进展生存期(FPS)>1年、总生存期(OS)>3年比例显著低于各基因正常组,但在国际预后指数(IPI)评分指标上却显著高于各基因正常组,差异具有统计学意义(P<0.05)。P53、PIMI及Bcl-2基因异常是患者的FPS、OS的独立影响因素。结论:Bcl-2、PIM1、P53基因在DLBCL患者的预后评估中具有重要的临床价值,且Bcl-2、PIM1、P53基因异常是患者预后不良的独立影响因素。Objective:To investigate the prognostic value of B lymphocyte-2 gene(Bcl-2),PIM1 and P53 gene abnormalities in diffuse large B-cell lymphoma(DLBCL).Methods:A total of 86 patients with DLBCL admitted to our hospital from March 2010 to March 2014 were enrolled.Interphase fluorescence in situ hybridization was used to detect Bcl-2,PIM1 and P53 genes.The patients were followed up for 5 years.Logistic multivariate regression analysis was used to analyze the relationship between Bcl-2,PIM1,P53 gene abnormalities and prognosis.Results:Among the 86 patients,29(33.72%)patients had P53 gene deletion;27(31.39%)patients had multiple copies of Bcl-2 gene,and 3(3.49%)patients had Bcl-2 gene translocation;PIMI gene rearrangement occurred in patients(23.26%).There were no significant differences in gender,age of onset,invasion site,LDH level andβ2-MG level among patients with abnormal genes(P>0.05).However,the proportion of patients with abnormal genes in stage III^IV was significantly higher than that of I.~Phase II,the difference was statistically significant(P<0.05).The proportion of progress free survival(PFS)>1 year and overall survival(OS)>3 years in each abnormal group was significantly lower than that in the normal group,but the international prognostic index(IPI)score was significantly higher than the normal group,the difference was statistically significant(P<0.05).P53,PIMI and Bcl-2 gene abnormalities are independent factors affecting patients'FPS and OS.Conclusion:Bcl-2,PIM1 and P53 genes have important clinical value in the prognosis evaluation of patients with DLBCL,and Bcl-2,PIM1 and P53 gene abnormalities are independent influencing factors for poor prognosis.

关 键 词：B淋巴细胞瘤-2基因 PIMI P53 弥漫大B细胞淋巴瘤 预后 

分 类 号：R733[医药卫生—肿瘤]