Huang Hui-Qiang, Pan Zhan-He, Lin Xu-Bin, Wang Bu-Fei, Hou Jing-Hui, Zhang Yu, Wu Qiu-Liang
State Key Laboratory of Oncology in South China, Guangzhou, Guangdong, 510060, P. R. China.
Ai Zheng. 2006 Dec;25(12):1517-23.
BACKGROUND & OBJECTIVE: Peripheral T-cell lymphoma (PTCL) is a group of heterogeneous malignancy with poor prognosis. The role of international prognostic index (IPI) in PTCL remains to be determined. It is necessary to find new molecular markers for PTCL. This study was to evaluate the clinical significance of nm23-H1 and MUC-1 in predicting the prognosis of PTCL.
The expression of nm23-H1 and MUC-1 proteins in 96 specimens of PTCL was detected by SP immunohistochemistry. The correlations of nm23-H1 and MUC-1 expression to clinical features, objective response, and overall survival of PTCL patients were analyzed.
Of the 96 patients, 78 (81.2%) were nm23-H1-positive, 56 (58.3%) were MUC-1-positive. Neither of the expression of nm23-H1 and MUC-1 was correlated to the pathologic subtype of PTCL (P>0.05). The high expression of nm23-H1 was associated with some poor prognostic factors such as stage III-IV, performance status (PS)> or =2, extranodal involvement, and more than one site of extranodal involvement (P<0.05). The high expression of MUC-1 was only associated with stage III-IV and more than one site of extranodal involvement (P<0.05). Of the 89 patients with evaluable disease, the overall response rate was 87.8% with a complete remission (CR) rate of 56.7%. The CR rate was significantly higher in nm23-H1-negative patients than in nm23-H1-positive patients (66.7% vs. 55.4%, P<0.05), and significantly higher in the patients with low nm23-H1 expression than in those with high nm23-H1 expression (79.9% vs. 44.0%, P<0.05); the CR rate was higher in MUC-1-negative patients than in MUC-1-positive patients, and higher in the patients with low MUC-1 expression than in those with high MUC-1 expression, but the differences were not significant. The median follow-up of the whole group was 30 months (range, 2-98 months), and the median survival time was 32 months [95% confidence interval (CI)= 26-34 months]. The overall 5-year survival rate of the whole group was 35.1%. The overall 5-year survival rate was significantly higher in nm23-H1-negative patients than in nm23-H1-positive patients (86.7% vs. 24.9%, P=0.001), and significantly higher in the patients with low nm23-H1 expression than in those with high nm23-H1 expression (52.3% vs. 21.7%, P<0.001). The overall 5-year survival rate was slightly higher in MUC-1-negative patients than in MUC-1-positive patients (47.9% vs. 28.5%, P>0.05), and slightly higher in the patients with low MUC-1 expression than in those with high MUC-1 expression (46.2% vs. 22.2%, P>0.05). Multivariant analysis showed that IPI score and nm23-H1 expression were independent prognostic factors of PTCL.
Overexpression of nm23-H1 is related to poor prognosis of PTCL; it may be a potential prognostic index of PTCL. Overexpression of MUC-1 is not related to.
外周T细胞淋巴瘤（PTCL）是一组异质性恶性肿瘤，预后较差。国际预后指数（IPI）在PTCL中的作用尚待确定。有必要寻找PTCL新的分子标志物。本研究旨在评估nm23-H1和MUC-1在预测PTCL预后中的临床意义。
采用SP免疫组化法检测96例PTCL标本中nm23-H1和MUC-1蛋白的表达。分析nm23-H1和MUC-1表达与PTCL患者临床特征、客观缓解情况及总生存的相关性。
96例患者中，78例（81.2%）nm23-H1阳性，56例（58.3%）MUC-1阳性。nm23-H1和MUC-1的表达均与PTCL的病理亚型无关（P>0.05）。nm23-H1高表达与一些不良预后因素相关，如Ⅲ-Ⅳ期、体能状态（PS）≥2、结外受累及多个结外部位受累（P<0.05）。MUC-1高表达仅与Ⅲ-Ⅳ期及多个结外部位受累相关（P<0.05）。89例可评估疗效的患者中，总缓解率为87.8%，完全缓解（CR）率为56.7%。nm23-H1阴性患者的CR率显著高于nm23-H1阳性患者（66.7%对55.4%，P<0.05），nm23-H1低表达患者显著高于高表达患者（79.9%对44.0%，P<0.05）；MUC-1阴性患者的CR率高于MUC-1阳性患者，低表达患者高于高表达患者，但差异无统计学意义。全组患者的中位随访时间为30个月（范围2-98个月），中位生存时间为32个月[95%置信区间（CI）=26-34个月]。全组5年总生存率为35.1%。nm23-H1阴性患者的5年总生存率显著高于nm23-H1阳性患者（86.7%对24.9%，P=0.001），nm23-H1低表达患者显著高于高表达患者（52.3%对21.7%，P<0.001）。MUC-1阴性患者的5年总生存率略高于MUC-1阳性患者（47.9%对28.5%，P>0.05），MUC-1低表达患者略高于高表达患者（46.2%对22.2%，P>0.05）。多因素分析显示，IPI评分和nm23-H1表达是PTCL的独立预后因素。
nm23-H1过表达与PTCL预后不良相关；它可能是PTCL的一个潜在预后指标。MUC-1过表达与之无关。
