Relationship of A 20mutation with clinicopathologic features and prognosis of diffuse large B cell lymphoma
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摘要: 目的：检查弥漫大B 细胞淋巴瘤（diffuse large B-cell lymphoma，DLBCL ）中肿瘤坏死因子诱导蛋白3 基因（tumornecro sisfactor ，alpha-inducedprotein 3 gene ，A 20基因）突变情况，探讨其对DLBCL 进展、预后及肿瘤耐药的影响。方法：收集104 例DLBCL 病例及其临床资料并随访部分病例，应用免疫组织化学染色检测肿瘤细胞中P-gP和Ki-67蛋白表达；聚合酶链反应扩增和DNA 测序检测A 20基因外显子3、6、7 突变情况；分析A 20基因与DLBCL 临床病理特征及预后的关系。结果：104 例DLBCL 中，A 20基因3 号外显子存在错义突变，总突变率17.3% 。其中第73位突变率在ABC-DLBCL与GCB-DLBCL病例之间差异具有统计学意义（18.5% vs . 2.5% ，P = 0.010）；在临床分期晚和高IPI 指数的DLBCL 病例中，A 20突变率明显高于相应的早临床分期和低IPI指数病例（P < 0.05）。 在A 20基因突变与未突变病例之间P-gP表达的差异有统计学意义（16/ 18vs. 52/ 86，P = 0.021），Ki-67低表达与高表达病例之间差异有统计学意义（低表达/ 高表达：1/ 17vs. 26/ 60，P = 0.030）；与未突变病例比较，A 20基因突变的DLBCL 病例复发率有增高的趋势（P = 0.06），生存状况较差（P = 0.016）。 结论：DLBCL 病例中A 20基因的突变对DLBCL 的临床病理特征及生存状况有一定影响，A 20基因突变可能是DLBCL 预后不良的相关因子。Abstract: Objective:To detect A 20mutation and to investigate its relationship with clinicopathologic features, prognosis, and re-sistance to therapy of diffuse large B cell lymphoma (DLBCL). Methods:A total of 104 cases with DLBCL and their clinical data were collected; follow-up was performed on a few of DLBCL patients. The expression of P-gP and Ki-67protein was detected with immuno -histochemical staining. The A 20gene mutation in exons 3, 6, and 7 were examined by polymerase chain reaction and DNA sequencing. Finally, the correlation of genetic abnormality of A 20with clinicopathologic features was analyzed. Results: Missense mutation in ex -on3 of A 20gene was identified in 18of 104 patients ( 17.3%). The A20gene mutation at site 73of exon3 was greater in the cases with activated B cell-like-DLBCL than with germinal center B-cell-like-DLBCL ( 18.5% vs . 2.5%,P=0.010). In contrast to the advanced clin -ical stage and high International Prognostic Index (IPI) cases, the rate of A 20mutation was superior to the opposite ( P<0.05). The ex -pression for P-gP was higher in the cases with mutation than that of those with wild-type A 20gene (16/18vs . 52/86, P=0.021). The dif -ference in A20mutation between the groups of low and high positive expression for Ki- 67(1/17vs . 26/60, P=0.030) was significant. DLBCL with A20mutation had an increasing recurrence tendency (P=0.06) and a worse survival ( P=0.016) compared with those with wild-type A 20gene.Conclusion:The A20mutation has a certain influence on the clinicopathologic characteristics and survival condi-tions of BLBCL patients. Probably, A20mutation is a factor associated with a poor prognosis of DLBCL.
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期刊类型引用(7)
1. 徐睿欢，许娟，杨文秀. C-MYC/BCL2双表达弥漫大B细胞淋巴瘤组织中PIM1的表达及与临床病理特征的关系. 现代肿瘤医学. 2023(13): 2491-2496 . 
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2. 许娟，杨文秀，冯江龙，濮珍红，杨光，沈丹丹. C-Myc/Bcl-2蛋白双表达弥漫大B细胞淋巴瘤中C-Myc、Bcl-2和Bcl-6基因重排的检测及临床意义. 肿瘤. 2021(04): 257-267 . 百度学术
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4. 韩莹，杨文秀，濮珍红，万珑. MicroRNA-125a-5p表达对弥漫大B细胞淋巴瘤耐药及临床预后的影响. 中国现代医学杂志. 2018(19): 34-40 . 百度学术
5. 冯江龙，杨文秀，王佳蕊，李泊. A20基因缺失对弥漫大B细胞淋巴瘤临床病理特征和预后的影响及相关分子机制研究. 重庆医学. 2017(19): 2594-2598 . 百度学术
6. 冯江龙，杨文秀，王佳蕊，濮珍红，韩莹，万珑. A20基因缺失对弥漫大B细胞淋巴瘤P-gp表达影响. 中华肿瘤防治杂志. 2017(11): 750-754 . 百度学术
7. 濮珍红，杨文秀，韩莹. 弥漫大B细胞淋巴瘤中miR-125a-5p的表达及其意义. 实用医学杂志. 2017(17): 2864-2868 . 百度学术
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