[C-myc表达在T淋巴母细胞淋巴瘤/白血病中的意义及其与预后的关系]
[Significance of C-myc expression in T-lymphoblastic lymphoma/leukemia and its relation with prognosis].
作者信息
Zhang Yanhua, Li Jing, Xi Yanfeng, Bai Wenqi, Bai Wei, Sun Ruifang
机构信息
Shanxi Medical University, Taiyuan 030013, China.
Department of Pathology, Shanxi Tumor Hospital, Taiyuan 030013, China.
出版信息
Zhonghua Bing Li Xue Za Zhi. 2015 Aug;44(8):571-7.
OBJECTIVE
To study the C-myc gene and protein in T lymphoblastic lymphoma/leukemia (T-LBL/ALL) and its relationship to prognosis.
METHODS
60 cases of T-LBL/ALL with follow-up data were studied by using immunohistochemical EnVision method for CD1a, CD3, εCD3, CD7, CD10, CD34, CD43, CD45RO, CD99, TDT, CD20, CD23, MPO, Ki-67 and C-myc. 20 cases of reactive lymph nodes were selected as normal control group of C-myc gene and protein. Fluorescence in-situ hybridization (FISH) for C-myc gene (located on chromosome8q24) was performed to detect its breakage and gain.
RESULTS
Among the 60 cases of T-LBL/ALL, immunohistochemistry results showed:the percentages of tumor cells expression of CD1a, CD3, εCD3, CD7, CD10, CD34, CD43, CD45RO, CD99 and TDT were 38.3% (23/60), 75.0% (45/60), 45.0% (27/60), 95.0% (57/60), 36.7% (22/60), 23.3% (14/60), 60.0% (36/60), 41.7% (25/60), 96.7% (58/60) and 93.3% (56/60). Separately, while CD20, CD23 and MPO were all negative. A figure of Ki-67 expression ≤ 80% was found in 36 cases and > 80% was found in 24 cases. The positive rate of C-myc protein was 66.7% (40/60) in 60 cases of T-LBL/ALL, was 0% (0/20) in 20 cases of reactivated lymphoid tissue (χ² = 26.67, P < 0.05). C-myc protein expression was positively correlated with the mediatinal width and Ki-67 index (P < 0.05). Fluorescence in-situ hybridization results showed that among the 60 cases of T-LBL/ALL, C-myc gene with breakage of 8q24 was detected in 6 cases (10.0%), and gains in 11 cases (18.3%). 20 cases of reactive lymph nodes were not occurred breakage and gains of C-myc gene. It is not significant between C-myc gene and protein expression (P > 0.05). In addition, in 60 cases of T-LBL/ALL, 12(20.0%) cases of C-myc protein and genetic abnormalities coexist. Log-rank analysis results: The prognosis of C-myc protein positive group was worse than negative group (P < 0.05). The relationship of C-myc gene and prognosis was not significant (P > 0.05). C-myc protein and genetic abnormality coexist is related with worse prognosis (P < 0.05). COX analysis results show that the C-myc protein positive group may be a independent poor prognosis factors (P < 0.05).
CONCLUSIONS
C-myc may play an important role on the development of T-LBL/ALL. It may be a independent prognosis factors.
目的
研究C-myc基因及蛋白在T淋巴母细胞淋巴瘤/白血病（T-LBL/ALL）中的表达及其与预后的关系。
方法
采用免疫组织化学EnVision法检测60例有随访资料的T-LBL/ALL患者的CD1a、CD3、εCD3、CD7、CD10、CD34、CD43、CD45RO、CD99、TDT、CD20、CD23、MPO、Ki-67及C-myc。选取20例反应性淋巴结作为C-myc基因及蛋白的正常对照组。采用荧光原位杂交（FISH）法检测位于8号染色体8q24的C-myc基因的断裂及扩增情况。
结果
60例T-LBL/ALL患者免疫组化结果显示：肿瘤细胞CD1a、CD3、εCD3、CD7、CD10、CD34、CD43、CD45RO、CD99及TDT的表达率分别为38.3%（23/60）、75.0%（45/60）、45.0%（27/60）、95.0%（57/60）、36.7%（22/60）、23.3%（14/60）、60.0%（36/60）、41.7%（25/60）、96.7%（58/60）及93.3%（56/60）。CD20、CD23及MPO均为阴性。Ki-67表达≤80%者36例，>80%者24例。60例T-LBL/ALL患者中C-myc蛋白阳性率为66.7%（40/60），20例反应性淋巴组织中C-myc蛋白阳性率为0%（0/20）（χ² = 26.67，P < 0.05）。C-myc蛋白表达与纵隔增宽及Ki-67指数呈正相关（P < 0.05）。荧光原位杂交结果显示：60例T-LBL/ALL患者中，检测到C-myc基因8q24断裂6例（10.0%），扩增11例（18.3%）。20例反应性淋巴结未检测到C-myc基因的断裂及扩增。C-myc基因与蛋白表达差异无统计学意义（P > 0.05）。此外，60例T-LBL/ALL患者中，C-myc蛋白与基因异常共存12例（20.0%）。Log-rank分析结果显示：C-myc蛋白阳性组预后较阴性组差（P < 0.05）。C-myc基因与预后关系不显著（P > 0.05）。C-myc蛋白与基因异常共存者预后较差（P < 0.05）。COX分析结果显示：C-myc蛋白阳性组可能是独立的预后不良因素（P < 0.05）。
结论
C-myc可能在T-LBL/ALL的发生发展中起重要作用，可能是独立的预后因素。
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