文章摘要
胡 杰,刘素娜,李 斌,喻镁佳,陈 琪.Bcl-2、PIM1、P53基因异常在弥漫大B细胞淋巴瘤中的预后价值[J].,2020,(11):2179-2183
Bcl-2、PIM1、P53基因异常在弥漫大B细胞淋巴瘤中的预后价值
Prognostic Value of Bcl-2, PIM1 and P53 Gene Abnormalities in Diffuse Large B-cell Lymphoma
投稿时间:2020-01-24  修订日期:2020-02-18
DOI:10.13241/j.cnki.pmb.2020.11.039
中文关键词: B淋巴细胞瘤-2基因  PIMI  P53  弥漫大B细胞淋巴瘤  预后
英文关键词: B lymphoma-2 gene  PIM1  P53  Diffuse large B-cell lymphoma  Prognosis
基金项目:云南省科技厅-昆明医科大学应用基础研究联合基金项目(2018FE001(-266))
作者单位
胡 杰 云南省第二人民医院血液科 云南 昆明 650000 
刘素娜 云南省第二人民医院血液科 云南 昆明 650000 
李 斌 云南省第二人民医院血液科 云南 昆明 650000 
喻镁佳 云南省第二人民医院血液科 云南 昆明 650000 
陈 琪 云南省第二人民医院血液科 云南 昆明 650000 
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中文摘要:
      摘要 目的:探讨B淋巴细胞瘤-2基因(Bcl-2)、PIM1及P53基因异常在弥漫大B细胞淋巴瘤(DLBCL)中的预后价值。方法:选取在2010年3月~2014年3月期间我院收治的DLBCL患者86例进行研究。采用间期荧光原位杂交检测Bcl-2、PIM1、P53基因。对患者进行为其5年的随访,采用Logistic多因素回归分析Bcl-2、PIM1、P53基因异常与预后的关系。结果:在86例患者中,29例(33.72%)患者存在P53基因缺失;27例(31.39%)患者发生Bcl-2基因多拷贝,3例(3.49%)患者发生Bcl-2基因易位;26例(23.26%)患者发生PIMI基因重排。各基因异常患者在性别、发病年龄、侵犯部位、LDH水平及β2-MG水平上比较,差异均无统计学意义(P>0.05);但是各基因异常患者Ⅲ~Ⅳ期的比例显著高于Ⅰ~Ⅱ期,差异具有统计学意义(P<0.05)。各基因异常组患者的无进展生存期(FPS)>1年、总生存期(OS)>3年比例显著低于各基因正常组,但在国际预后指数(IPI)评分指标上却显著高于各基因正常组,差异具有统计学意义(P<0.05)。P53、PIMI及Bcl-2基因异常是患者的FPS、OS的独立影响因素。结论:Bcl-2、PIM1、P53基因在DLBCL患者的预后评估中具有重要的临床价值,且Bcl-2、PIM1、P53基因异常是患者预后不良的独立影响因素。
英文摘要:
      ABSTRACT Objective: To investigate the prognostic value of B lymphocyte-2 gene (Bcl-2), PIM1 and P53 gene abnormalities in diffuse large B-cell lymphoma(DLBCL). Methods: A total of 86 patients with DLBCL admitted to our hospital from March 2010 to March 2014 were enrolled. Interphase fluorescence in situ hybridization was used to detect Bcl-2, PIM1 and P53 genes. The patients were followed up for 5 years. Logistic multivariate regression analysis was used to analyze the relationship between Bcl-2, PIM1, P53 gene abnormalities and prognosis. Results: Among the 86 patients, 29 (33.72%) patients had P53 gene deletion; 27 (31.39%) patients had multiple copies of Bcl-2 gene, and 3(3.49%) patients had Bcl-2 gene translocation; PIMI gene rearrangement occurred in patients(23.26%). There were no significant differences in gender, age of onset, invasion site, LDH level and β2-MG level among patients with abnormal genes (P>0.05). However, the proportion of patients with abnormal genes in stage III~IV was significantly higher than that of I. ~ Phase II, the difference was statistically significant (P<0.05). The proportion of progress free survival(PFS)>1 year and overall survival(OS)>3 years in each abnormal group was significantly lower than that in the normal group, but the international prognostic index(IPI)score was significantly higher than the normal group, the difference was statistically significant(P<0.05). P53, PIMI and Bcl-2 gene abnormalities are independent factors affecting patients' FPS and OS. Conclusion: Bcl-2, PIM1 and P53 genes have important clinical value in the prognosis evaluation of patients with DLBCL, and Bcl-2, PIM1 and P53 gene abnormalities are independent influencing factors for poor prognosis.
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