TP53突变和缺失对弥漫大B细胞淋巴瘤患者预后影响的研究  

Prognostic value of TP53 mutation and deletion on patients with DLBCL

作　　者：古佳 白斯君[2] 耿晔[2] 贺建霞[2] GU Jia;BAI Sijun;GENG Ye;HE Jianxia(Department of Hematology,Jincheng People's Hospital,Shanxi Jincheng 048000,China;Department of Hematology,The Fifth Clinical Medical College of Shanxi Medical University,Shanxi Provincial People's Hospital,Shanxi Taiyuan 030012,China)

机构地区：[1]晋城市人民医院血液科,山西晋城048000 [2]山西医科大学第五临床医学院,山西省人民医院血液科,山西太原030012

出　　处：《现代肿瘤医学》2024年第3期518-523,共6页Journal of Modern Oncology

基　　金：山西省自然科学基金(编号:201901D111435)。

摘　　要：目的:探讨TP53突变和缺失对弥漫大B细胞淋巴瘤(diffuse large B-cell lymphoma, DLBCL)患者预后的影响。方法:收集我院2017至2020年94例初发DLBCL患者的石蜡病理组织,应用免疫组化及二代测序检测TP53突变,FISH技术检测TP53缺失,分析TP53突变、缺失与临床病理及分子分型的相关性,以及对生存的影响。应用COX回归分析DLBCL的生存影响因素。结果:27.7%(26/94)患者过表达p53,23.5%(19/81)患者存在TP53突变,16.0%(15/94)患者TP53缺失,结外受累(P=0.027)、MUM-1(P=0.04)及p53蛋白(P<0.01)表达在在TP53突变和/或缺失及TP53正常两组中存在明显差异。生存分析显示,“双阳性(TP53突变合并缺失)”组生存最差,“双阴性(无TP53突变及缺失)”组预后最好,TP53突变或缺失则次之,其中单突变与单缺失两组总生存无明显统计学差异(P=0.689),其余各组之间生存有显著差异(P<0.05)。GCB中,TP53突变组预后较差(P=0.046)。多因素分析显示合并B症状、TP53异常及双表达是影响DLBCL生存的独立危险因素。结论:TP53突变或缺失,特别是同时合并突变和缺失是DLBCL的不良预后因素,在新的分子分型中,其预后意义仍值得进一步的深入研究。ANO1,also known as TMEM16A,as one of the molecular identities of calcium-activated voltage-dependent chloride channels,is widely distributed in a variety of tissues and organs in the body,mediating bronchial gland secretion,nociception,intestinal slow wave formation and other physiological functions.At the same time,ANO1 is involved in the occurrence and development of various pathological processes,such as malignant tumors,inflammation.Several reports have confirmed that the high expression of ANO1 is induced by multifold signaling pathways in the pathogenesis of malignant tumor,and then the high expression of ANO1 enhances the malignant biological behavior of tumor cells by activating different downstream signaling pathways.In this review,we focused on the possible mechanism by which the high expression of ANO1 in malignant tumor enhancing the malignant biological behavior of tumor cells.

关 键 词：弥漫大B细胞淋巴瘤 TP53 突变 缺失 预后 

分 类 号：R733.4[医药卫生—肿瘤]