| 于 婷,季 杰,包 琴,姜 凯,雍宁静.外周血NETs、TP53、STAT3表达与弥漫性大B细胞淋巴瘤临床病理及预后的关系分析[J].,2023,(5):996-1000 |
| 外周血NETs、TP53、STAT3表达与弥漫性大B细胞淋巴瘤临床病理及预后的关系分析 |
| Relationship of Peripheral Blood NETs, TP53 and STAT3 Expression with Clinical Pathology and Prognosis of Diffuse Large B-cell Lymphoma |
| 投稿时间：2022-06-22 修订日期：2022-07-18 |
| DOI：10.13241/j.cnki.pmb.2023.05.039 |
| 中文关键词: 弥漫性大B细胞淋巴瘤 中性粒细胞胞外诱捕网 TP53 信号转导与转录因子3 病理特征 预后 |
| 英文关键词: Diffuse large B-cell lymphoma Neutrophil extracellular traps TP53 Signal transducer and activator of transcription 3 Pathological feature Prognosis |
| 基金项目:成都医学科研项目（2020050） |
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| 中文摘要: |
| 摘要 目的：探究外周血中性粒细胞胞外诱捕网（NETs）、TP53、信号转导与转录因子3（STAT3）表达与弥漫性大B细胞淋巴瘤（DLBCL）临床病理及预后的关系。方法：选取2020年3月-2021年12月收治的71例DLBCL患者作为研究对象，抽取患者外周静脉血，采用R-CHOP方案进行治疗，记录患者外周血NETs、TP53、STAT3表达情况并分析DLBCL患者外周血NETs、TP53、STAT3表达与其临床病理及预后的关系。结果：髓细胞组织增生蛋白（MYC）阳性在TP53阳性中的占比显著高于TP53阴性，差异有统计学意义（x2=28.844，P＜0.001）；Hans分型生发中心B细胞（GCB）在STAT3阳性中的占比显著高于STAT3阴性（x2=4.331，P=0.037），其余差异无统计学意义（P>0.05）；随访截止至2022年6月，随访时长8~28个月，71例患者中共53例缓解DLBCL患者，其余18例为R/R DLBCL患者；NETs阳性、TP53阳性、STAT3阳性患者无进展生存期（PFS）显著低于NETs阴性、TP53阴性、STAT3阴性患者，差异有统计学意义（P<0.05）且NETs阳性、TP53阳性、STAT3阳性患者存活率均低于NETs阴性、TP53阴性、STAT3阴性患者（P<0.05）；单因素分析结果显示Ann Arbor分期、NETs、TP53、STAT3为DLBCL患者的影响因素（P<0.05）；以患者预后情况（R/R DLBCL=1，缓解DLBCL=0）为因变量，将Ann Arbor分期、NETs、TP53、STAT3单因素分析有统计学意义的因素纳入COX回归模型中，结果显示：NETs、TP53、STAT3为DLBCL患者预后的危险因素（P<0.05）。结论：TP53、STAT3表达与DLBCL临床病理存在一定相关性，临床应对DLBCL患者TP53、STAT3表达情况引起重视；NETs、TP53、STAT3表达为DLBCL预后的危险因素，可作为DLBCL患者不良预后的预测指标。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the relationship of peripheral blood neutrophil extracellular traps (NETs), TP53 and signal transducer and activator of transcription 3(STAT3) expression with clinical pathology and prognosis of diffuse large B-cell lymphoma (DLBCL). Methods: A total of 71 patients with DLBCL who were treated with the R-CHOP regimen from March 2020 to December 2021 were selected as the research subjects. Peripheral blood samples were collected from the patients to detect the expression of NETs, TP53 and STAT3. The relationship of peripheral blood NETs, TP53 and STAT3 expression with clinical pathology and prognosis was analyzed. Results: The proportion of myelocytomatosis protein (MYC) positive patients in TP53 positive patients was significantly higher than that in TP53 negative ones (x2=28.844, P<0.001). The proportion of germinal center B-cell (GCB) in STAT3 positive patients was significantly higher than that in STAT3 negative ones (x2=4.331, P=0.037), and the other differences were not statistically significant (P>0.05). The patients were followed up for 8-28 months. 53 patients were relieved and 18 patients had R/R DLBCL. The progression-free survival(PFS) time and survival rates of NETs-positive, TP53-positive, and STAT3-positive patients were significantly shorter/lower than those of NETs-negative, TP53-negative, and STAT3-negative patients (P<0.05). Univariate analysis showed that Ann Arbor stage, NETs, TP53, and STAT3 were influencing factors of DLBCL (P<0.05). With the prognosis (R/R DLBCL=1, remission DLBCL=0) as the dependent variable, factors with statistically significant differences were included in the COX regression model, and the analysis results showed that NETs, TP53 and STAT3 were prognostic factors in patients with DLBCL(P<0.05). Conclusion: TP53 and STAT3 expression is related to clinical pathology of DLBCL. NETs, TP53 and STAT3 are prognostic factors of DLBCL, and can be used as predictors for poor prognosis in patients with DLBCL. In clinical practice, attention should be paid to the expression of NETs, TP53 and STAT3 in patients with DLBCL. |
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