HBV相关弥漫大B细胞淋巴瘤临床特征、BCL-2、CMYC表达及预后分析

发布时间：2018-04-26 19:17

本文选题：弥漫大B细胞性淋巴瘤 + HBV　；参考：《安徽医科大学学报》2017年04期

【摘要】：目的探讨乙型肝炎病毒(HBV)相关弥漫大B细胞淋巴瘤(DLBCL)临床特征、BCL-2、CMYC表达的相关性及预后分析。方法回顾性分析94例DLBCL患者病例资料。利用免疫组化法检测其肿瘤组织石蜡切片中BCL-2、CMYC蛋白表达的情况,分析HBV相关DLBCL患者的临床特征、蛋白表达及预后比较。结果 1 94例DLBCL患者中乙肝感染率(Hbs Ag+)为27.66%,明显高于普通人群(7.18%);Hbs Ag(+)组DLBCL患者与Hbs Ag(-)组相比:疾病分期更晚(P=0.032)、国际预后指数(IPI)评分更高(P=0.047)、脾脏更易受累(P=0.02);在性别分布、年龄、免疫学亚型、化疗疗程方面无显著差异;2两组在BCL-2、CMYC蛋白表达方面:Hbs Ag(+)组BCL-2蛋白表达明显高于Hbs Ag(-)组(84.6%vs 58.8%,P=0.018),在CMYC蛋白表达、BCL-2/CMYC"双表达"方面无显著差异;3单因素生存分析显示乙肝病毒感染、BCL-2阳性、CMYC阳性、CMYC/BCL-2双表达、IPI高危组均为总生存期(OS)和无疾病进展生存期(PFS)的不良预后因素;Cox多因素分析显示,CMYC/BCL-2双表达、IPI高危组均为OS、PFS独立的不良预后因素。结论 HBV相关弥漫大B细胞淋巴瘤具有独特的临床特征;HBV感染、BCL-2、CMYC、BCL-2/CMYC双表达、IPI均与DLBCL预后相关;HBV感染可能通过调控BCL-2作用影响DLBCL发生发展及预后。
[Abstract]:Objective to investigate the clinical features of DLBCLs associated with hepatitis B virus hepatitis B virus (HBV) and to investigate the correlation and prognosis of the expression of BCL-2 and CMYC in patients with diffuse large B cell lymphoma (DLBCLs). Methods the data of 94 cases of DLBCL were analyzed retrospectively. The expression of BCL-2mCMYC protein in paraffin sections of tumor tissues was detected by immunohistochemical method, and the clinical features, protein expression and prognosis of patients with HBV related DLBCL were analyzed. Results the infection rate of hepatitis B in 94 patients with DLBCL was 27.66, which was significantly higher than that of the general population (7.18%). Compared with Hbs Ag-group, the disease stage was later than that of Hbs group. The score of international prognosis index was higher than that of Hbs group. Immunological subtypes, There was no significant difference between the two groups in the expression of BCL-2mCMYC protein. The expression of BCL-2 protein in the group of BCL-2CMYC was significantly higher than that in the group of Hbs Ag-1.The expression of BCL-2 protein in the two groups was significantly higher than that in the Hbs group (84.6 vs 58.8%). There was no significant difference in the expression of BCL-2CMYC "double expression" between the two groups. 3 univariate survival analysis showed that there was no significant difference in the expression of BCL-2CMYC between the two groups. The negative prognostic factors of CMYC / BCL-2 double expression of CMYC / BCL-2 in high risk group of IPI (total survival time) and disease free survival time (PFSs). Cox multivariate analysis showed that the high risk group with double expression of CMYC / BCL-2 and IPI were independent prognostic factors of OSPFS. The results of Cox multivariate analysis showed that the high risk group with double expression of CMYC / BCL-2 and IPI were independent prognostic factors of OSPFS. Conclusion HBV associated diffuse large B cell lymphoma has unique clinical features. Both BCL-2 and CMYCL-2 / CMYC double expression and prognosis of DLBCL may influence the development and prognosis of DLBCL by regulating the role of BCL-2.
【作者单位】：安徽医科大学第一附属医院血液内科;
【基金】：安徽省高等学校省级自然科学研究重点项目(编号:KJ2011A164)
【分类号】：R733.1;R512.62

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