首页|MYC蛋白与BCL-2蛋白双表达DLBCL患者临床特点与预后影响因素分析

MYC蛋白与BCL-2蛋白双表达DLBCL患者临床特点与预后影响因素分析

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目的 分析细胞致瘤基因(cellular-myelocytomatosis viral oncogene,MYC)蛋白与B细胞淋巴瘤基因-2(B cell lymphoma/lewkmia-2,BCL-2)蛋白双表达弥漫大B细胞淋巴瘤(diffuse large B-cell lymphoma,DLBCL)患者的临床特点与预后影响因素。方法 选取 2020 年 1 月—2021 年 1 月南京医科大学附属苏州医院收治的 82 例DLBCL患者,均行免疫组化检测MYC蛋白与BCL-2 蛋白表达情况,并连续随访 3 年,统计患者的生存时间,分析预后影响因素。结果 MYC/BCL-2 蛋白双表达组DLBCL患者改良Ann-Arbor分期Ⅲ~Ⅳ期、肿瘤包块直径≥5 cm、淋巴瘤国际预后指数(international prognostic score,IPS)评分 3~4 分及骨髓侵犯占比均高于非MYC/BCL-2 蛋白双表达组,差异有统计学意义(P<0。05)。MYC/BCL-2 蛋白双表达组DLBCL患者平均生存时间为(22。35±2。48)个月,非MYC/BCL-2蛋白双表达组平均生存时间为(30。70±1。66)个月,MYC/BCL-2 蛋白双表达组DLBCL患者平均生存时间低于非MYC/BCL-2 蛋白双表达组,差异有统计学意义(P<0。001)。logistic回归分析显示,改良Ann-Arbor分期Ⅲ~Ⅳ期、骨髓侵犯、MYC/BCL-2 蛋白双表达为影响DLBCL患者预后的危险因素(P<0。05)。结论 MYC蛋白与BCL-2 蛋白双表达DLBCL患者临床特征主要表现为分期晚、肿瘤大包块、更易发生骨髓侵犯且预后差;MYC蛋白与BCL-2 蛋白双表达可作为DLBCL患者预后的影响因素。文章中体现了《中国弥漫大B细胞淋巴瘤诊断与治疗指南(2013 年版)》的临床参考或执行标准。
Analysis of Clinical Features and Prognostic Influence Factors in DLBCL Patients With Double Expression of MYC Protein and BCL-2 Protein
Objective To analyze the clinical features and prognostic influence factors on cellular myelocytomatosis viral oncogene(MYC)protein and B cell lymphoma/lewkmia-2(BCL-2)protein double express diffuse large B-cell B-cell lymphoma(DLBCL).Methods A total of 82 DLBCL patients admitted to the Affiliated Suzhou Hospital of Nanjing Medical University from January 2020 to January 2021 were selected,and the expression of MYC protein and BCL-2 protein were detected by immunohistochemistry,and the survival time was analyzed for 3 years,the influencing factors of prognosis were analyzed.Results The improved Ann-Arbor stage Ⅲ to Ⅳ stage,tumor mass diameter≥5 cm and international prognostic index score(IPS)3-4 scores and the proportion of bone marrow invasion of DLBCL patients in the MYC/BCL-2 double-protein expression group were higher than those in the non-MYC/BCL-2 double-protein expression group,the differences were statistically significant(P<0.05).The mean survival time for patients with DLBCL in the MYC/BCL-2 double-protein expression group was(22.35±2.48)months,while the mean survival time for patients in the non-MYC/BCL-2 double-protein expression group was(30.70±1.66)months,the mean survival time of patients with DLBCL in the MYC/BCL-2 double-protein expression group was shorter than that in the non-MYC/BCL-2 double-protein expression group,the differences were statistically significant(P<0.001).The logistic regression analysis showed that modified Ann-Arbor stage(stage Ⅲ to Ⅳ),bone marrow invasion,and double expression of MYC/BCL-2 protein were the risk factors affecting the prognosis of DLBCL patients(P<0.05).Conclusion The clinical characteristics of patients with BLBCL include late stage,tumor mass,more prone to bone marrow invasion and poor prognosis;and double expression of MYC protein and BCL-2 protein can be used as the prognosis factor of DLBCL patients.The article reflects the clinical reference or implementation criteria of the"Chinese Guidelines for Diagnosis and Treatment of Diffuse large B-cell Lymphoma(2013 edition)".

diffuse large B-cell lymphomaMYC proteinBCL-2 proteindouble expressionprognosisinfluence factors

周越、刘俊秀

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南京医科大学附属苏州医院/苏州市立医院血液科,江苏 苏州 215001

弥漫大B细胞淋巴瘤 MYC蛋白 BCL-2蛋白 双表达 预后 影响因素

2024

中国卫生标准管理
《中国卫生标准管理》杂志社

中国卫生标准管理

影响因子:1.374
ISSN:1674-9316
年,卷(期):2024.15(23)