CMYC、BCL2、BCL6蛋白表达与弥漫性大B细胞淋巴瘤临床病理特征及预后的关系  

The relationship between CMYC,BCL2 and BCL6 protein expression and clinicopathological characteristics and prognosis of diffuse large B-cell lymphoma

作　　者：原玉芬 张萍 王富强 杨海军 程柯源 YUAN Yu-fen;ZHANG Ping;WANG Fu-qiang;YANG Hai-jun;CHENG Ke-yuan(Department of Pathology,Anyang Tumor Hospital(The Fourth Affiliated Hospital of Henan University of Science and Technology),Anyang 455000,China;School of Clinical Medicine,Jishou University,Jishou City,Xiangxi Prefecture,Hunan Province,Jishou 410000,China)

机构地区：[1]安阳市肿瘤医院(河南科技大学第四附属医院)病理科,安阳455000 [2]湖南省湘西州吉首市吉首大学临床医学院,吉首410000

出　　处：《天津医科大学学报》2021年第4期374-378,共5页Journal of Tianjin Medical University

摘　　要：目的:探讨细胞性骨髓细胞瘤病病毒癌基因(CMYC)、B细胞白血病/淋巴瘤因子-2基因(BCL2)与B细胞白血病/淋巴瘤因子-6基因(BCL6)蛋白表达与弥漫性大B细胞淋巴瘤(DLBCL)临床病理特征及预后的关系。方法:纳入2013年1月—2017年1月于安阳市肿瘤医院就诊的DLBCL患者84例,收集病理组织标本,免疫组化法检测CMYC、BCL2与BCL6蛋白的表达,分析CMYC、BCL2与BCL6蛋白的表达与DLBCL临床病理特征关系。根据治疗结果分为预后良好组与预后不良组,比较两组3种蛋白及其他因素差异,分析影响DLBCL预后不良的危险因素,评价CMYC、BCL2与BCL6蛋白表达与预后的关系。结果:84例DLBCL组织中CMYC、BCL2、BCL6蛋白阳性率分别为85.71%、92.86%、88.10%。Ann Arbor分期Ⅲ~Ⅳ期、有骨髓侵犯的CMYC、BCL2与BCL6蛋白阳性率高于Ann Arbor分期Ⅰ~Ⅱ期、无骨髓侵犯(均P<0.05)。预后不良组CMYC阳性率、BCL2阳性率、BCL6阳性率、Ann Arbor分期Ⅲ~Ⅳ期占比、P53阳性率、CD5阳性率均高于预后良好组(均P<0.05)。Logistic回归分析显示CMYC阳性、BCL2阳性、BCL6阳性、Ann Arbor分期Ⅲ~Ⅳ期、P53阳性、CD5阳性均是影响DLBCL患者预后不良的危险因素(均P<0.05)。经Spearman秩相关性分析,DLBCL患者预后不良与CMYC、BCL2、BCL6阳性率呈正相关(r=0.769、0.884、0.798,均P<0.05)。结论:CMYC、BCL2、BCL6蛋白在DLBCL患者中特异性高表达,可反映Ann Arbor分期、骨髓侵犯等病理特征。Objective:To investigate the relationship between the expression of cellular-myelocytomatosis viral oncogene(CMYC),B-cell leukemia/lymphoma factor-2 gene(BCL2)and B-cell leukemia/lymphoma factor-6 gene(BCL6)proteins and the clinicopathological characteristics and prognosis of diffuse large B-cell lymphoma(DLBCL).Methods:A total of 84 DLBCL patients were enrolled in the Anyang Cancer Hospital.They were admitted to the hospital from January 2013 to January 2017.Pathological tissue specimens were collected.Immunohistochemical method was used to detect the expression of CMYC,BCL2 and BCL6 proteins,and analyze the relationship between the expression of CMYC and BCL2,BCL6 protein and the clinicopathological characteristics of DLBCL.According to the treatment results,they were divided into a good prognosis group and a poor prognosis group.The differences were compared that in the 3 proteins and other possible influencing factors of the two groups,the risk factors affecting the poor prognosis of DLBCL were clarified,and the relationship was evaluated between CMYC,BCL2 and BCL6 protein expression and prognosis.Results:The positive rates of CMYC,BCL2,and BCL6 protein in 84 DLBCL tissues were 85.71%,92.86%,and 88.10%,respectively.The positive rate of CMYC,BCL2 and BCL6 protein in Ann Arbor stage Ⅲ-Ⅳ with bone marrow invasion were higher than those of Ann Arbor stage Ⅰ-Ⅱ,without bone marrow invasion(all P<0.05).The proportions of CMYC positive rate,BCL2 positive rate,BCL6 positive rate,and Ann Arbor stage Ⅲ-Ⅳ stages,P53 positive rate and CD5 positive rate in the poor prognosis group were higher than those in the good prognosis group(all P<0.05).Logistic regression analysis showed that CMYC positive,BCL2 positive,BCL6 positive,Ann Arbor stages Ⅲ-Ⅳ,P53 positive,and CD5 positivewere all risk factors affecting the poor prognosis of DLBCL patients(all P<0.05).Spearman rank correlation analysis showed that the poor prognosis of DLBCL patients was positively correlated with the positive rates of CMYC,BCL2,and BCL6(r

关 键 词：弥漫性大B细胞淋巴瘤 CMYC BCL2 BCL6 

分 类 号：R733[医药卫生—肿瘤]