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[Bcl-2基因表达及其对原发性胃肠道弥漫性大B细胞淋巴瘤患者预后的影响]

[Expression of Bcl-2 gene and its effect on prognosis of patients with primary gastrointestinal diffuse large B-cell lymphoma].

作者信息

Zhang Le, Zhao Haifeng, Li Xiaowu, Xia Bing, Zheng Hong, Li Haixin, Sun Baocun, Zhang Yizhuo

机构信息

Department of Hematological Oncology, Tianjin Cancer Institute and Hospital, Tianjin 300060, China.

Email:

出版信息

Zhonghua Zhong Liu Za Zhi. 2014 Oct;36(10):755-60.

Abstract

OBJECTIVE

To explore the expression of Bcl-2 mRNA and its effect on prognosis of patients with primary gastrointestinal diffuse large B-cell lymphoma (PGI-DLBCL).

METHODS

Real time quantitative PCR was used to determine the expression of Bcl-2 mRNA in 40 PGI-DLBCL patients and 17 healthy controls. The association of Bcl-2 expression with clinicopathological features and prognosis of the patients was analyzed.

RESULTS

The expression level of Bcl-2 mRNA in PGI-DLBCL patients was 1.03 ± 0.93, significantly higher than that of the controls (0.41 ± 0.21) (P < 0.05). The expression of Bcl-2 mRNA in stage IIE-IV patients (1.28 ± 1.01) was significantly higher than that in the stage I-II2 patients (0.62 ± 0.61) (P < 0.05). The expression of Bcl-2 mRNA in patients with international prognostic index (IPI) score >2 (1.95 ± 1.27) was significantly higher than those with IPI score ≤ 2 (0.86 ± 0.75)(P < 0.05). The expression of Bcl-2 mRNA in patients with complete remission (CR) (0.71 ± 0.58) was significantly lower vs. 2.42 ± 0.91 in patients with no CR (P < 0.05). Univariate analysis indicated that β2-MG, IPI score>2, the Lugano staging, and Bcl-2 mRNA expression were associated with overall survival (OS) and progression-free survival (PFS) (P < 0.05). Multivariate analysis indicated that IPI score>2 was independently associated with OS (P < 0.05), and both IPI score >2 and Bcl-2 mRNA expression were independently associated with PFS (P < 0.05).

CONCLUSIONS

The expression of Bcl-2 mRNA in the tumor tissue of PGI-DLBCL patients is significantly higher than that in controls. PGI-DLBCL patients with higher expression of Bcl-2 have a poor chemotherapy response and inferior prognosis. IPI score >2 and higher expression of Bcl-2 mRNA are independent poor prognostic factors for PFS in PGI-DLBCL patients.

摘要

目的

探讨Bcl-2 mRNA的表达及其对原发性胃肠道弥漫性大B细胞淋巴瘤(PGI-DLBCL)患者预后的影响。

方法

采用实时定量PCR检测40例PGI-DLBCL患者及17例健康对照者Bcl-2 mRNA的表达。分析Bcl-2表达与患者临床病理特征及预后的相关性。

结果

PGI-DLBCL患者Bcl-2 mRNA表达水平为1.03±0.93,显著高于对照组(0.41±0.21)(P<0.05)。ⅡE-IV期患者Bcl-2 mRNA表达(1.28±1.01)显著高于Ⅰ-II2期患者(0.62±0.61)(P<0.05)。国际预后指数(IPI)评分>2的患者Bcl-2 mRNA表达(1.95±1.27)显著高于IPI评分≤2的患者(0.86±0.75)(P<0.05)。完全缓解(CR)患者Bcl-2 mRNA表达(0.71±0.58)显著低于未达到CR的患者(2.42±0.91)(P<0.05)。单因素分析表明,β2-MG、IPI评分>2、卢加诺分期及Bcl-2 mRNA表达与总生存期(OS)和无进展生存期(PFS)相关(P<0.05)。多因素分析表明,IPI评分>2与OS独立相关(P<0.05),IPI评分>2和Bcl-2 mRNA表达均与PFS独立相关(P<0.05)。

结论

PGI-DLBCL患者肿瘤组织中Bcl-2 mRNA表达显著高于对照组。Bcl-2表达较高的PGI-DLBCL患者化疗反应差,预后不良。IPI评分>2及Bcl-2 mRNA高表达是PGI-DLBCL患者PFS的独立不良预后因素。

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