摘要
背景:Bcl-2基因转录异常与结内弥漫大B细胞淋巴瘤(DLBCL)关系密切,对Bcl-2与原发性胃肠道DLBCL(PGI-DLBCL)的关系则缺乏充分研究。目的:探讨PGI-DLBCL中Bcl-2基因扩增和蛋白表达与肿瘤临床病理特征、免疫表型和预后的关系。方法:采集136例手术治疗PGI-DLBCL患者的临床资料,电话随访生存信息。以荧光原位杂交技术检测肿瘤组织Bcl-2基因扩增,免疫组化法检测Bcl-2蛋白表达,分析两者与肿瘤临床病理特征、免疫表型和预后的关系。结果:136例患者中,33例(24.3%)Bcl-2基因扩增阳性,90例(66.2%)Bcl-2蛋白表达阳性;基因扩增与肿瘤原发部位、Ann Arbor分期、血清乳酸脱氢酶水平、B症状、国际预后指数(IPI)评分相关(P<0.05),蛋白表达与肿瘤原发部位和免疫表型相关(P<0.05)。Bcl-2基因扩增阳性患者和免疫表型为非GCB型的Bcl-2蛋白表达阳性患者5年总生存率(OS)分别显著低于相应阴性患者(41.5%对71.5%,P<0.05;54.6%对84.6%,P<0.05)。Bcl-2基因扩增或蛋白表达阳性患者中,CHOP化疗的5年OS显著低于利妥昔单抗联合CHOP化疗(48.6%对80.3%,P<0.05;66.4%对83.4%,P<0.05)。结论:检测Bcl-2基因扩增对PGI-DLBCL的预后判断具有重要意义,检出Bcl-2基因扩增者预后较差。非GCB型PGI-DLBCL中,Bcl-2蛋白表达与预后不良相关。利妥昔单抗可提高Bcl-2基因扩增或蛋白表达阳性患者的生存率。
Background： Aberrant Bcl-2 transcription is closely related with nodal diffuse large B-cell lymphoma （DLBCL）, however, the relationship between Bcl-2 and primary gastrointestinal DLBCL （PGI-DLBCL） was not fully studied.Aims： To investigate the relationship between Bcl-2 gene amplification and protein expression and clinicopathological characteristics, immunophenotype and prognosis of PGI-DLBCL.Methods： Clinical data was collected from 136 PGI-DLBCL patients receiving surgical treatment, and a telephone interview was conducted for survival information.Bcl-2 gene amplification and protein expression in tumor tissue were determined by fluorescence in situ hybridization and immuno-histochemistry, respectively, and relationships between Bcl-2 and clinicopathological characteristics, immunophenotype and prognosis of PGI-DLBCL were analyzed.Results： Among 136 PGI-DLBCL patients, 33 （24.3%） showing gene amplification and 90 （66.2%） showing protein expression of Bcl-2;gene amplification was correlated with primary tumor location, Ann Arbor stage, serum lactate dehydrogenase level, B symptom and International Prognostic Index （IPI） score （P〈0.05）, while protein expression was correlated with primary tumor location and immunophenotype （P〈0.05）.5-year overall survival （OS） in patients positive for Bcl-2 gene amplification and patients with non-GCB immunophenotype and positive for Bcl-2 protein expression were inferior to those negative ones （41.5%vs.71.5%, P〈0.05;54.6% vs.84.6%, P〈0.05）.In Bcl-2 gene amplification or protein expression positive patients, 5-year OS of CHOP chemotherapy was inferior to that of rituximab combined with CHOP chemotherapy （48.6%vs.80.3%, P〈0.05;66.4%vs.83.4%, P〈0.05）.Conclusions： Detection of Bcl-2 gene amplification is useful for prediction of prognosis in PGI-DLBCL.Both patients with Bcl-2 gene amplification and non-GCB patients with Bcl-2 protein expression have a poorer prognosis.Rituximab may improve the prognosis in patients with
作者
韩琪
范姝琼
张子臻
沈丹平
刘佳骅
陈奕宽
韩虎林
付海花
苏欣莹
殷晓璐
倪醒之
HAN Qi FAN Shuqiong ZHANG Zizhen SHEN Danping LIU Jiahua CHEN Yikuan HAN Hulin FU Haihua SU Xinying YIN Xiaolu NI Xingzhi(Department of Gastrointestinal Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai （200127 AstraZeneca R＆D, Shanghai)
出处
《胃肠病学》
2017年第5期266-271,共6页
Chinese Journal of Gastroenterology
关键词
胃肠肿瘤
淋巴瘤
大B细胞
弥漫性
免疫表型分型
预后
Gastrointestinal Neoplasms
Lymphoma
Large B-Cell
Diffuse
Immunophenotyping
Prognosis
