c-Myc在胃黏膜相关淋巴组织淋巴瘤患者预后评估中的意义

摘要

目的 探讨c-Myc在胃黏膜相关淋巴组织(MALT)淋巴瘤中的表达及对预后的影响.方法 回顾性分析2009年-2015年就诊于青岛市中心医院胃肠外科的79例胃MALT淋巴瘤患者的临床资料,其中低危胃MALrT淋巴瘤38例,高危胃MALT淋巴瘤20例,胃弥漫大B细胞淋巴瘤(DLBCL)21例.Real-time PCR分析淋巴瘤及其毗邻正常组织中c-Myc的表达水平,结合临床资料评价其表达与患者预后的关系.结果 低危胃MALT淋巴瘤、高危胃MALT淋巴瘤和胃DLBCL患者中c-Myc mRNA的阳性表达率分别为15.7％ (6/38)、25％(5/20)和28.5％(6/21);且随着疾病的进展,低危胃MALT淋巴瘤、高危胃MALT淋巴瘤和胃DLBCL患者c-Myc mRNA的表达水平逐渐升高,肿瘤大小及浸润深度也可影响c-Myc的表达.生存分析显示c-Myc表达阳性患者的总生存率及无复发生存率均低于c-Myc阴性患者(P＜0.05).结论 c-Myc参与了胃MALT淋巴瘤的恶性转化,可能在胃MALT淋巴瘤的发生发展中发挥作用.%Objective To investigate the expression of c-Myc in gastric mucosa associated lymphoid tissue (MALT) lymphoma and its implications on prognosis.Methods The clinical data of 79 patients hospitalized in our hospital from 2009 to 2015 were retrospectively analyzed.In these patients,38 patients were low-grade MALT lymphoma,20 patients were high-grade MALT lymphoma,21 patients were diffused large B cell lymphoma (DLBCL).Real-time PCR was used to detect the levels of c-Myc expression in gastric MALT tissues and pair-matched adjacent normal tissues.The relationship between the expression of c-Myc and prognosis of patients was evaluated combing with the clinical data.Results Compared with the normal tissues,the expression levels of c-Myc protein were 15.7％ (6/38),25％ (5/20) and 28.5％ (6/21)in patients with low-grade MALT lymphoma,high-grade MALT lymphoma,and DLBCL.The relative expression levels of cMyc mRNA were gradually elevated in low-grade MALT lymphoma,high-grade MALT lymphoma and DLBCL.The tumor size and depth of invasion can influence the expression level of c-Myc.Survival analysis found that the overall survival rates and relapse-free survival rates were lower in patients with c-Myc positive expression than those of patients with negative expression (P ＜ 0.05).Conclusion C-Myc plays a key role in the malignant transformation of gastric MALT lymphoma.