摘要
目的探讨弥漫性大B细胞淋巴瘤（DLBCL）中myc基因重排和蛋白表达及其与预后的相关性。方法采用免疫组织化学EnVision法检测106例DLBCL患者肿瘤组织中CD3、CDIO、CD20、bcl-6、多发性骨髓瘤原癌基因1（Mum-1）和myc蛋白的表达情况，采用荧光原位杂交（FISH）技术检测myc基因重排。结果106例DLBCL肿瘤组织中，myc、Mum-1、CD10和bcl-6阳性率分别为70．8％、56．6％、21．7％和26．4％。106例DLBCL患者中，生发中心样（GCB）26例（24．5％），非生发中心样（non—GCB）80例（75．5％）；myc基因重排13例（12．3％），均为non—GCB型，与myc蛋白表达无关。myc基因重排的DLBCL患者预后极差，中位总生存时间和无进展生存时间分别为4．7个月和3．2个月。多因素生存分析显示，myc基因重排、ECOG评分、免疫分型和myc蛋白表达为影响DLBCL患者预后的独立因素，且myc基因重排的预后预测意义最强。结论myc基因重排可作为评价DLBCL患者预后的生物学参考指标。myc蛋白表达受多种调控因素影响，基因重排可能为其中因素之-。
Objective To study the relationship between myc gene rearrangement and myc protein expression in diffuse large B cell lymphoma （DLBCL） , and their correlation with prognosis. Methods One hundred and six cases of DLBCLs with follow-up data were analyzed using interphase fluorescence in situ hybridization （FISH） technique. Immunophenotyping analysis for CD20, CD3, myc, Mum-1, CD10, bcl-6 was also performed using EnVision immunohistochemistry. Results The percentages of tumor cells expressing myc, Mum-1, CD10 and bcl-6 were 70.8% , 56.6% , 21.7% and 26.4% , respectively. Twenty six cases（24.5% ）were of GCB type and the rest（75.5% ）were of non-GCB （non germinal center） type. The myc rearrangement was identified in 13 （ 12.3% ） of 106 cases. 13 cases showed to be of non-GCB type. There was no correlation between myc rearrangement and myc protein expression. DLBCLs （ n = 13 ） with myc rearrangement showed significantly poorer overall survival （OS） and progression free survival （PFS） , with a median OS and PFS time of 4.7 and 3.2 months, respectively （for OS and PFS, P 〈 0. 001 ）. Multivariate analysis using Cox proportional hazard model confirmed that myc rearrangement, ECOG performance status of 2-4, immunophenotyping subgroup and myc protein were independent factors affecting the prognosis and significantly associated with the survival. However, myc rearrangement was the strongest prognostic factor. Conclusions DLBCL with myc gene rearrangement is a subgroup of non-GCB DLBCL with poor outcome. It is an independent and useful factor for prognosis in DLBCL. Expression of mye is influenced by many factors and myc rearrangement may be one of these factors.
出处
《中华肿瘤杂志》
CAS
CSCD
北大核心
2013年第2期119-123,共5页
Chinese Journal of Oncology
基金
山西省青年科技研究基金（2007021055、2010021035-5）
关键词
淋巴瘤
基因重排
原位杂交
荧光
预后
Lymphoma
C-ene rearrangement
In situ hybridization, fluorescence
Prognosis
