甲基转移酶EZH2表达水平对原发性胃肠道弥漫大B细胞淋巴瘤患者临床疗效及远期预后的预测价值分析  

Analysis of the Predictive Value of EZH2 Expression Level on the Clinical Efficacy and Long-term Prognosis of Patients with Primary Gastrointestinal Diffuse Large B-cell Lymphoma

作　　者：林剑扬[1] 郑艳彬[1] 何鸿鸣[1] 王杰松[1] 杨瑜[1] 陈道光[1] 邹思平[1] 王畅 LIN Jian-Yang;ZHENG Yan-Bin;HE Hong-Ming;WANG Jie-Song;YANG Yu;CHEN Dao-Guang;ZOU Si-Ping;WANG Chang(Department of Lymphoma and Head and Neck Cancer,The Affiliated Tumor Hospital of Fujian Medical University,Fuzhou 350014,Fujian Province,China)

机构地区：[1]福建省肿瘤医院淋巴瘤及头颈肿瘤内科,福建医科大学附属肿瘤医院,福建福州350014

出　　处：《中国实验血液学杂志》2021年第3期725-730,共6页Journal of Experimental Hematology

基　　金：福建省科技计划项目资助(2018Y2003)。

摘　　要：目的:探讨甲基转移酶EZH2表达水平对原发性胃肠道弥漫大B细胞淋巴瘤(PGI-DLBCL)患者的临床疗效及远期预后的预测价值。方法:选择2013年8月-2019年7月本院161例初治的PGI-DLBCL患者,检测其EZH2蛋白表达水平,比较不同水平EZH2患者的近期疗效及远期生存差异;Log-rank检验及COX风险比例回归模型统计分析EZH2表达水平对PGI-DLBCL预后的预测价值;卡方检验及Logistic回归法分析EZH2表达水平的影响因素。结果:EZH2高表达患者完全缓解率、总缓解率均明显低于低表达患者(P <0.001)。EZH2高、低水平表达组中位总生存期(OS)及无进展生存期(PFS)分别为37、31个月和49、42个月,高水平表达组累积OS和PFS率均明显低于低水平表达组,差异均有统计学意义(P <0.05)。H3K27me3、EZH2、BCL-2、BCL-6、c-MYC高表达与患者OS和PFS缩短密切相关,Ki-67高表达与患者OS缩短密切相关(P <0.05),其中H3K27me3、EZH2、BCL-2、BCL-6高表达为患者OS和PFS缩短的独立危险因素。EZH2表达水平与H3K27me3、BCL-6、c-MYC、Ki-67表达水平均呈正相关(r=0.741,r=0.837,r=0.809,r=0.772),其中H3K27me3、BCL-6、Ki-67高表达为EZH2高表达的独立影响因素。结论:在PGI-DLBCL患者中,EZH2高表达明显降低近期完全缓解率、总缓解率,是远期OS、PFS率缩短的独立危险因素,与H3K27me3、BCL-6高表达呈独立相关。Objective:To investigate the predictive value of methyltransferase EZH2 expression level on the clinical efficacy and long-term prognosis of patients with primary gastrointestinal diffuse large B-cell lymphoma(PGI-DLBCL).Methods:161 patients with newly treated PGI-DLBCL in our hospital from August 2013 to July 2019 were selected.The expression level of EZH2 protein was detected by immunohistochemistry,and the short-term efficacy and long-term survival differences of patients with different levels of EZH2 were compared.The predictive values of EZH2 expression level on the short-term efficacy and long-term prognosis of PGI-DLBCL patients were analyzed by Log-rank test and COX risk proportional regression model.Chi-square test and Logistic regression analysis were used to analyze the influencing factors of EZH2 expression level.Results:The complete response(CR) and overal response(OR) rates of those with high EZH2 expression were significantly lower than those with low EZH2 expression(P <0.001).The median OS and PFS of EZH2 high-level and low-level expression group was 37,31 months and 49,42 months,respectively.The cumulative OS and PFS rates of the high-level expression group were significantly lower than those of the low-level expression group,and the differences were statistically significant(P <0.05).The high expression levels of H3 K27 me3,EZH2,BCL-2,BCL-6,c-MYC were closely related to the shortening of OS and PFS,while the high expression level of Ki-67 was closely related to the shortening of OS(P <0.05),of which the high expression levels of H3 K27 me3,EZH2,BCL-2,and BC.L-6 were independent risk factors for shortening of OS and PFS.The expression level of EZH2 was positively correlated with the expression level of H3 K27 me3,BCL-6,c-MYC and Ki-67(r=0.741,r=0.837,r=0.809,r=0.772),and the high expression levels of H3 K27 me3,BCL-6 and Ki-67 were independent factors influencing the high expression of EZH2.Conclusion:In patients with PGI-DLBCL,the high expression of EZH2 significantly reduces the short-term CR a

关 键 词：EZH2 弥漫大B细胞淋巴瘤 胃肠道 

分 类 号：R733.1[医药卫生—肿瘤]