弥漫性大B细胞淋巴瘤肿瘤微环境中PTEN、FOXP3和STAT3的表达及临床病理学意义  

Expression of PTEN,FOXP3 and STAT3 proteins in the tumor microenvironment of diffuse large B-cell lymphoma

作　　者：于靖雯 李君娜 王小树 马文梅 庞雪莲[1] 崔文丽[1] YU Jing-wen;LI Jun-na;WANG Xiao-shu;MA Wen-mei;PANG Xue-lian;CUI Wen-li(Department of Pathology,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830000,China)

机构地区：[1]新疆医科大学第一附属医院病理科,乌鲁木齐830000

出　　处：《诊断病理学杂志》2025年第2期175-181,共7页Chinese Journal of Diagnostic Pathology

基　　金：国家自然科学基金地区科学基金项目(82360046,82060038);“天山英才”医药卫生高层次人才培养计划(TSYC202301A009);CSCO恒瑞肿瘤研究基金项目面上课题(YHR2020QN-0153)。

摘　　要：目的探讨弥漫性大B细胞淋巴瘤(DLBCL)肿瘤微环境中PTEN缺失、FOXP3和STAT3蛋白表达并阐述其临床病理意义。方法回顾性收集120例DLBCL患者蜡块,运用免疫组化技术(IHC)检测PTEN、FOXP3和STAT3蛋白的表达并作相关统计分析。结果PTEN蛋白阳性率30.8%(37/120);PTEN缺失率达69.2%(83/120),其中55%(66/120)为GCB型,14.2%(17/120)为non-GCB型;FOXP3阳性率81.7%(98/120),STAT3阳性率50%(60/120),FOXP3低表达患者比例为37.5%(45/120);高表达患者比例为44.2%(53/120),STAT3低表达患者比例为9.2%(11/120);STAT3高表达患者比例为40.8%(49/120);PTEN缺失、FOXP3和STAT3高表达均与骨髓累及、IPI评分及PS评分相关(P<0.05),STAT3高表达与肿瘤直径相关(P<0.05);PTEN缺失与FOXP3、STAT3高表达均呈负相关(P<0.05),单因素及多因素生存分析显示IPI评分高危组、PS评分和PTEN缺失是影响DLBCL患者预后的独立危险因素(P<0.05)。结论PTEN在DLBCL肿瘤细胞中缺失率较高,并且在GCB型中显著缺失;PTEN缺失和STAT3高表达可作为评价DLBCL恶性程度或预后的指标之一,FOXP3是调节性T细胞(Treg)最特异的生物标志物,其表达水平可为DLBCL恶性程度提供参考价值。Objective To investigate PTEN deletion,FOXP3 and STAT3 protein expression in the tumor microenvironment of diffuse large B-cell lymphoma and to elaborate its clinicopathological significance.Methods Paraffin-embedded tissue blocks from 120 patients with DLBCL were collected retrospectively,and the expression of PTEN,FOXP3 and STAT3 proteins was detected by immunohistochemistry(IHC)and analyzed statistically.Results The positive rate of PTEN protein was 30.8%(37/120).The deletion rate of PTEN was 69.2%(83/120),of which 55%(66/120)was GCB type and 14.2%(17/120)was non-GCB type.The positive rate of FOXP3 was 81.7%(98/120),the positive rate of STAT3 was 50%(60/120),and the proportion of patients with low expression of FOXP3 was 37.5%(45/120).The high expression rate of STAT3 was 44.2%(53/120),and the low expression rate of STAT3 was 9.2%(11/120).The proportion of patients with high expression of STAT3 was 40.8%(49/120).PTEN deletion,high expression of FOXP3 and STAT3 were related to bone marrow involvement,IPI score and PS score(P<0.05),and high expression of STAT3 was related to tumor size(P<0.05).The loss of PTEN expression was negatively correlated with the high expression of FOXP3 and STAT3(P<0.05).Univariate and multivariate survival analyses showed that high-risk group with IPI score,PS score and loss of PTEN expression were independent risk factors affecting the prognosis of patients with DLBCL(P<0.05).Conclusion Loss of PTEN expression in DLBCL tumor cells is most commonly found,and it is significantly absent in GCB type;PTEN loss and high expression of STAT3 can be used as one of the indicators to evaluate the malignant degree or prognosis of DLBCL,and FOXP3 is the most specific biomarker of regulatory T cells(Treg),and its expression level can provide reference value for the malignant degree of DLBCL.

关 键 词：弥漫大B细胞淋巴瘤 PTEN FOXP3 STAT3 肿瘤微环境 预后 

分 类 号：R733.4[医药卫生—肿瘤]