Department of Hematology, the People's Hospital of Taizhou, Taizhou.
Institute of Translational Medicine, Medical College, Yangzhou University.
Medicine (Baltimore). 2021 Jan 29;100(4):e24449. doi: 10.1097/MD.0000000000024449.
In patients with diffuse large B-cell lymphoma, MYC combined with Bcl2 and/or Bcl6-based protein expression is called double expression lymphoma (DEL). R-DA-EPOCH program chemotherapy is typically recommended because these patients often have a poor prognosis. Although numerous factors affect survival of patients with DEL, the roles of the tumor biomarker histone methyltransferase G9a (G9a) and the lymphocyte-to-monocyte ratio (LMR) are unknown.We performed a retrospective analysis of data from 51 patients. These patients were newly diagnosed with DEL and treated with R-DA-EPOCH at Taizhou People' s Hospital and Northern Jiangsu People's Hospital between June 2014 and December 2019. Receiver operator characteristic curve results were used to calculate the LMR cutoff value. We used an immunohistochemical analysis to examine G9a expression in DEL tissues. The Kaplan-Meier method was used to determine progression-free survival (PFS) and overall survival (OS) characteristics. Cox proportional-hazards models were constructed for univariate and multivariate analyses to examine the prognostic values of LMRs and G9a in patients with DEL.The cutoff value for LMR was 2.18. The 5-year PFS rate was 35.3%, and the 5-year OS rate was 39.2%. Patients with DEL with lower LMRs and who were G9a-positive predicted inferior PFS and OS. Univariate analysis revealed that patients with elevated LDH levels, high National Comprehensive Cancer Network International Prognostic Index (NCCN-IPI) scores, LMRs ≤2.18, and G9a-positive results had relatively poorer PFS and OS. The multivariate analysis revealed that LMRs ≤2.18 and a G9a-positive result were independent prognostic factors for PFS and OS in patients with DEL treated with R-DA-EPOCH.The study results suggested that peripheral blood LMRs were an important marker for evaluation of prognosis in patients with DEL. High expression of G9a was associated with worse outcomes, indicating that G9a may serve as a prognostic biomarker for patients with DEL who undergo R-DA-EPOCH program chemotherapy.
在弥漫性大 B 细胞淋巴瘤患者中，MYC 与基于 Bcl2 和/或 Bcl6 的蛋白表达相结合被称为双表达淋巴瘤（DEL）。通常推荐使用 R-DA-EPOCH 方案化疗，因为这些患者的预后往往较差。尽管许多因素影响 DEL 患者的生存，但肿瘤生物标志物组蛋白甲基转移酶 G9a（G9a）和淋巴细胞与单核细胞比值（LMR）的作用尚不清楚。我们对 2014 年 6 月至 2019 年 12 月在泰州人民医院和苏北人民医院接受 R-DA-EPOCH 治疗的 51 例新诊断为 DEL 的患者进行了回顾性数据分析。使用受试者工作特征曲线结果计算 LMR 截止值。我们使用免疫组织化学分析检测 DEL 组织中的 G9a 表达。使用 Kaplan-Meier 方法确定无进展生存期（PFS）和总生存期（OS）特征。构建 Cox 比例风险模型进行单因素和多因素分析，以检查 LMR 和 G9a 在 DEL 患者中的预后价值。LMR 的截止值为 2.18。5 年 PFS 率为 35.3%，5 年 OS 率为 39.2%。LMR 较低且 G9a 阳性的 DEL 患者预测 PFS 和 OS 较差。单因素分析显示，LDH 水平升高、NCCN-IPI 评分高、LMRs≤2.18 和 G9a 阳性的患者 PFS 和 OS 较差。多因素分析显示，LMRs≤2.18 和 G9a 阳性是 R-DA-EPOCH 治疗的 DEL 患者 PFS 和 OS 的独立预后因素。研究结果表明，外周血 LMRs 是评估 DEL 患者预后的重要标志物。G9a 的高表达与预后较差相关，表明 G9a 可能是接受 R-DA-EPOCH 方案化疗的 DEL 患者的预后生物标志物。
