CAJ | 학술논문

目的探讨Bcl-2 mRNA在原发性胃肠道弥漫大B细胞淋巴瘤(PGI-DLBCL)中的表达情况及其对患者预后的影响.方法采用实时荧光定量PCR法检测40例PGI-DLBCL组织、17例正常对照组织中Bcl-2 mRNA的表达水平,分析Bcl-2的表达与PGI-DLBCL患者临床病理特征的关系及其对患者预后的影响.结果 PGI-DLBCL组患者Bcl-2 mRNA的表达水平为1.03 ±0.93,高于对照组(0.41±0.21),差异有统计学意义(P =0.008 9).ⅡE～Ⅳ期患者Bcl-2 mRNA的表达水平(1.28±1.01)高于Ⅰ～Ⅱ2期患者(0.62 ±0.61,P＜0.05),国际预后指数(IPI)评分＞2分的患者Bcl-2mRNA表达水平(1.95±1.27)高于IPI评分≤2分者(0.86±0.75,P＜0.05),化疗后达到完全缓解者Bcl-2 mRNA的表达水平(0.71±0.58)明显低于未达完全缓解者(2.42±0.91,P＜0.05).单因素分析结果显示,β2微球蛋白水平、Lugano分期、IPI评分和Bcl-2 mRNA表达水平与患者的总生存时间(OS)和无进展生存时间(PFS)均有关(均P＜0.05).多因素分析结果显示,IPI评分是影响OS的独立因素(P =0.008),IPI评分和Bcl-2 mRNA表达为影响PFS的独立因素(均P＜0.05).结论 Bcl-2mRNA在PGI-DLBCL患者肿瘤组织中的表达水平高于正常对照组,其中表达水平较高者对化疗不敏感,预后不佳.IPI评分＞2分和Bcl-2 mRNA高表达是影响PGI-DLBCL患者PFS的独立不良因素.
목적 탐토Bcl-2 mRNA재원발성위장도미만대B세포림파류(PGI-DLBCL)중적표체정황급기대환자예후적영향.방법 채용실시형광정량PCR법검측40례PGI-DLBCL조직、17례정상대조조직중Bcl-2 mRNA적표체수평,분석Bcl-2적표체여PGI-DLBCL환자림상병리특정적관계급기대환자예후적영향.결과 PGI-DLBCL조환자Bcl-2 mRNA적표체수평위1.03 ±0.93,고우대조조(0.41±0.21),차이유통계학의의(P =0.008 9).ⅡE～Ⅳ기환자Bcl-2 mRNA적표체수평(1.28±1.01)고우Ⅰ～Ⅱ2기환자(0.62 ±0.61,P＜0.05),국제예후지수(IPI)평분＞2분적환자Bcl-2mRNA표체수평(1.95±1.27)고우IPI평분≤2분자(0.86±0.75,P＜0.05),화료후체도완전완해자Bcl-2 mRNA적표체수평(0.71±0.58)명현저우미체완전완해자(2.42±0.91,P＜0.05).단인소분석결과현시,β2미구단백수평、Lugano분기、IPI평분화Bcl-2 mRNA표체수평여환자적총생존시간(OS)화무진전생존시간(PFS)균유관(균P＜0.05).다인소분석결과현시,IPI평분시영향OS적독립인소(P =0.008),IPI평분화Bcl-2 mRNA표체위영향PFS적독립인소(균P＜0.05).결론 Bcl-2mRNA재PGI-DLBCL환자종류조직중적표체수평고우정상대조조,기중표체수평교고자대화료불민감,예후불가.IPI평분＞2분화Bcl-2 mRNA고표체시영향PGI-DLBCL환자PFS적독립불량인소.
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 Ⅱ E-Ⅳ patients (1.28 ± 1.01) was significantly higher than that in the stage Ⅰ-Ⅱ 2 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 β32-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.