目的：观察结直肠原发弥漫大B细胞淋巴瘤（ DLBCL）细胞中HES1 mRNA的表达变化，并探讨其与肿瘤预后的关系。方法结直肠DLBCL患者60例，术中取肿瘤组织和瘤旁正常组织，采用激光显微切割法联合real-time PCR法检测HES1 mRNA。根据检测结果将患者分为HES1高表达组和HES1低表达组，比较两组总生存率（OS）和无复发生存率（RFS）。采用单因素分析及Cox回归多因素分析法分析肿瘤预后相关因素。结果60例患者肿瘤细胞中HES1 mRNA表达量为0．6±0．08，瘤旁正常组织中HES1 mRNA表达量为1．2±0．10，二者相比，P＜0．05。 HES1高表达组OS为（53．0±1．4）个月、RFS为（28．8±1．2）个月，HES1低表达组分别为（38．6±1．3）、（20．6±1．1）个月，两组相比，P均＜0．05。单因素分析结果显示，年龄、IPI评分、瘤体直径、肿瘤是否突破浆膜层、LDH、HES1 mRNA表达水平是结直肠原发DLBCL的预后相关因素。多因素Cox回归分析结果显示，HES1 mRNA低表达对OS和RFS有正向提示作用（HR分别为1．134、1．102，P均＜0．01）。结论结直肠原发DLBCL细胞中HES1 mRNA表达降低，HES1 mRNA低表达与肿瘤不良预后有关。%Objective To observe the expression changes of HES1 mRNA in primary colorectal diffuse large B-cell lympho-ma (DLBCL) and its relationship with the prognosis.Methods The samples of 60 newly diagnosed primary colorectal DLBCL pa-tients were collected with Ficoll after approval of the ethics committee and informed consent .Lase microdissection combined with re-al-time PCR was used to test the mRNA expression of HES1 in the tumor tissues and adjacent tissues of 60 patients.According to the results, the patients were divided into HES1-high group and HES1-low group.The overall survival (OS) and relapse-free survival (RFS) of the tow groups were compared.The Univariate analysis and Multivariate Cox regression analysis were used to analyze the related factors for tumor prognosis.Results In 60 cases of patients, the expression level of HES1 mRNA was 0.6 ±0.08 in the tumor tissues and 1.2 ±0.10 in the adjacent normal tissues, significant difference was found between them (P<0.05).The results showed that the low-expression group had a shorter OS and shorter RFS as compared with those of the high-expression group (38.6 ±1.3 vs. 53.0 ±1.4 months, 20.6 ±1.8 months vs.28.8 ±1.2 months, respectively, all P<0.05).Univariate analysis showed that age, IPI score, the diameter of tumor, the breakthrough of serous layer, LDH and HES1 mRNA were the related factors for prognosis of color-ectal primary DLBCL.Multivariate Cox regression analysis showed that the low mRNA expression of HES1 had positive implications for OS and RFS (HR=1.134, 1.134, all P<0.01).Conclusion The expression of HES1 mRNA in the primary colorectal DLBCL was decreased, and the low expression was related with the poor prognosis .
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