摘要
目的分析弥漫大B细胞淋巴瘤患者外周血循环肿瘤细胞(CTC)中分化抗原47(CD47)、信号调节蛋白α(SIRP-α)、原癌基因(MYC)和增殖细胞相关抗原(Ki67)蛋白表达水平及其对肿瘤复发的预测效能。方法回顾性分析2018年1月至2021年1月山东省临沂市人民医院血液科收治的82例弥漫大B细胞淋巴瘤患者临床资料,均经组织病理学确诊,且接受化疗后缓解。其中男44例,女38例,年龄50~75(63.8±4.6)岁。根据患者缓解后1年内复发情况分为复发组(n=36)和未复发组(n=46)。采集患者晨起空腹外周静脉血4 ml,分离CTC,采用Western印迹法检测CTC中CD47、SIRP-α、MYC及Ki67蛋白表达水平。CD47表达水平与SIRP-α、MYC和Ki67表达水平的相关性采用Pearson相关性分析。采用受试者工作特征(receiver operating characteristic,ROC)曲线评估CD47、SIRP-α、MYC和Ki67表达水平对肿瘤复发的预测效能,并计算曲线下面积(AUC)。结果复发组患者CD47、SIRP-α、MYC、Ki67蛋白表达水平分别为2.24±0.23、1.17±0.12、1.98±0.20、2.63±0.27,未复发组分别为2.04±0.21、1.31±0.13、1.53±0.16、2.24±0.25,复发组患者CD47、MYC和Ki67表达水平高于未复发组,SIRP-α表达水平低于未复发组(均P<0.001)。82例患者中,CD47、SIRP-α、MYC和Ki67表达水平分别为2.13±0.22、1.25±0.13、1.73±0.18、2.41±0.26,CD47表达水平与SIRP-α表达水平呈负相关(r=-0.308,P=0.005),与MYC、Ki67表达水平呈正相关(r=0.484、0.332,P=0.012、0.003)。CD47、SIRP-α、MYC和Ki67表达水平预测弥漫大B细胞淋巴瘤复发的灵敏度分别为66.7%、72.2%、72.2%、66.7%,特异度分别为67.4%、71.7%、67.4%、71.7%,AUC(95%CI)分别为0.694(0.582~0.791)、0.693(0582~0.790)、0.714(0.603~0.808)、0.709(0.598~0.804);联合检测上述4项指标的灵敏度为83.3%,特异度为78.3%,AUC(95%CI)为0.864(0.771~0.930),均高于各指标单独检测(均P<0.05)。结论CD47表达水平与SIRP-α表达水平呈负相关,与MYC、Ki67表达水
Objective To analyze the expression levels of differentiation cluster 47(CD47),signal regulatory proteinα(SIRP-α),proto-oncogene(MYC)and proliferating cell associated antigen(Ki67)proteins in peripheral blood circulating tumor cells(CTC)from patients with diffuse large B-cell lymphoma and their predictive efficiency for tumor recurrence.Methods The data of 82 patients with diffuse large B-cell lymphoma who were confirmed by histopathology and were in remission after chemotherapy in the Hematology Department of Linyi People′s Hospital from January 2018 to January 2021 were retrospectively analyzed.There were 44 males and 38 females,and aged from 50 to 75(63.8±4.6)years.The patients were divided into recurrent group(n=36)and non-recurrent group(n=46)according to their recurrence within 1 year after remission.The fasting peripheral venous blood samples(4 ml)from patients in the morning were collected,and the CTC were isolated.The expression levels of CD47,SIRP-α,MYC and Ki67 proteins in CTC were detected by Western blotting.The correlations between CD47 expression level and SIRP-α,MYC and Ki67 expression levels were analyzed by Pearson correlation analysis.The predictive efficiency of CD47,SIRP-α,MYC and Ki67 expression levels on tumor recurrence was evaluated by receiver operating characteristic(ROC)curves,and the areas under the curve(AUC)were calculated.Results The expression levels of CD47,SIRP-α,MYC and Ki67 in recurrent group were 2.24±0.23,1.17±0.12,1.98±0.20 and 2.63±0.27,while those in non-recurrent group were 2.04±0.21,1.31±0.13,1.53±0.16 and 2.24±0.25.The expression levels of CD47,MYC and Ki67 in the recurrent group were higher than those in the non-recurrent group,while the expression levels of SIRP-αwere lower than those in the non-recurrent group(all P<0.001).In 82 patients,the expression levels of CD47,SIRP-α,MYC and Ki67 were 2.13±0.22,1.25±0.13,1.73±0.18 and 2.41±0.26,respectively.The expression level of CD47 was negatively correlated with the expression level of SIRP-α(r=-0.
作者
王超
周欣
刘广宇
曲春艳
袁长勇
张艳霞
Wang Chao;Zhou Xin;Liu Guangyu;Qu Chunyan;Yuan Changyong;Zhang Yanxia(Department of Hematology,Linyi People′s Hospital of Shandong Province,Linyi 276000,China;Department of Oncology,Linyi People′s Hospital of Shandong Province,Linyi 276000,China;Department of Orthopedics,Linyi People′s Hospital of Shandong Province,Linyi 276000,China;Department of Hematology and Oncology,Longkou People′s Hospital of Shandong Province,Longkou 265711,China;Department of Hematology,Dezhou People′s Hospital of Shandong Province,Dezhou 253000,China)
出处
《中华医学杂志》
CAS
CSCD
北大核心
2023年第17期1328-1333,共6页
National Medical Journal of China
关键词
淋巴瘤
B细胞
循环肿瘤细胞
复发
分化抗原47
信号调节蛋白α
Lymphoma,B-cell
Circulating tumor cells
Recurrence
Cluster of differentiation 47
Signal regulatory protein alpha
