E2F-1、NF-κB/P65、P-gp在弥漫性大B细胞淋巴瘤中的表达及意义

摘要

目的 研究E2F-1、NF-κB/ P65和P-gp在弥漫性大B细胞淋巴瘤(DLBCL)中的表达及意义.方法 应用免疫组织化学SP法检测E2F-1、NF-κB/ P65和P-gp在61例DLBCL和15例反应性增生淋巴结中的表达,分析E2F-1、NF-κB/ P65、P-gp表达与DLBCL临床病理特征和预后的关系.结果 ①61例DLBCL中,E2F-1表达的阳性率为42.6%,明显低于反应性增生的淋巴结(P<0.05);NF-κB/ P65和P-gp表达的阳性率分别为52.5%和54.1%,均高于淋巴结反应性增生(P<0.05).②61例DLBCL中,E2F-1的表达与NF-κB/ P65和P-gp的表达呈负相关,NF-κB/ P65和P-gp的表达呈正相关.③在DLBCL中,E2F-1的表达与患者的性别、年龄、Ann Arbor分期、IPI评分、LDH值及B症状均无关(P>0.05);NF-κB/ P65的表达与患者的Ann Arbor分期及IPI评分有关(P<0.05),与患者的性别、年龄、LDH值及B症状无关(P>0.05);P-gp的表达与患者的IPI评分有关(P<0.05),而与患者的性别、年龄、Ann Arbor分期、LDH值及B症状无关(P>0.05).④E2F-1阳性表达者5年生存率明显高于E2F-1阴性表达者,差异有统计学意义(P=0.03);NF-κB/P65阳性表达者5年生存率明显低于NF-κB/P65阴性表达者,差异有统计学意义(P=0.01);P-gp阳性表达者5年生存率虽然低于P-gp阴性表达者,但差异无统计学意义(P=0.12).结论 ①部分DLBCL患者存在原发性多药耐药.②在DLBCL中,E2F-1、NF-κB/ P65和P-gp之间存在相关性,提示三者在弥漫性大B细胞淋巴瘤中可能存在一定的相互作用,共同参与了肿瘤耐药.③E2F-1低表达和NF-κB/ P65高表达是DLBCL预后不良的指标.%Objective To investigate the expression and significance of E2F-1 ,NF-κB/ P65 and P-gp in diffuse large B cell lymphoma( DLBCL ). Methods Immunohistochemical SP method was used to detect the expression of E2F-1,NF-κB/ P65 and P-gp in 61 cases of diffuse large B cell lymphoma tissue and 15 cases of reactive hyperplasia lymph nodes. Their relationship with clinicopathologic parameters and prognosis were analyzed. Results ①Among the 61 cases of DLBCL tissue, the positive rates of E2F-1 was 42. 6% , which was significantly lower than that of reative hyperplasia lymph nodes( P < 0. 05 ); the positive rates of NF-κB/ P65 and P-gp were 52. 5% and 54. 1% respectively. The rates were significantly higer than reative hyperplasia lymph nodes( P < 0.05 ). ②Among the 61 cases of DLBCL tissue, the expression of E2F-1 was negatively correlated with the expression of NF-κB/ P65 and P-gp. The expression of NF-κB/ P65 was positively correlated with expression of P-gp. ③The expression of E2F-1 had no significant correlation wih gender,age,Ann Arbor stage,IPI score,LDH and B sympton( P>0.05 );The expression of NF-κB/ P65 was significantly correlated with Ann Arbor stage and IPI score( P < 0. 05 ), but not with gender, age, LDH and B sympton( P > 0. 05 ); The expression of P-gp had correlation with IPI score( P < 0. 05 ), but had no correlation with gender,age, Ann Arbor stage, LDH and B sympton ( P >0. 05 ). ④The 5-year survival rate of the E2F-1 positive patients was significantly higher than that of E2F-1 negative patients,the difference between them was significant( P = 0.03 );The 5-year survival rate of that of NF-κB/P65 positive patients was significantly lower than the NF-κB/ P65 negative patients,the difference between them was significant (P = 0.01 ); The 5-year survival rate of the P-gp positive patients was lower than the P-gp negative patients, but the difference was not significant (P =0. 12 ). Conclusion ①In DLBCL,some patients exist primar multidrug resistance. ② In DLBCL,E2F-1,NF-κB/ P65 and P-gp are correlated,which suggest that they may have a certain degree of intERαction and participate in the occurrence of tumor drug resistance. ③The low expression of E2F-1 and the high expression of NF-κB/ P65 are unfavourable prognostic indicators in DLBCL.