p-AXL与c-MYC和/或BCL-2共表达在弥漫大B细胞性淋巴瘤中的临床意义

缪娜波; 黎绮铭; 李淑华; 聂钊铭; 张芬芬; 彭挺生

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p-AXL与c-MYC和/或BCL-2共表达在弥漫大B细胞性淋巴瘤中的临床意义

临床研究 | 更新时间：2023-11-01

- p-AXL与c-MYC和/或BCL-2共表达在弥漫大B细胞性淋巴瘤中的临床意义
- Clinical Significance of Expression of p-AXL and Co-expression with c-MYC and/or BCL-2 in DLBCL
- 中山大学学报（医学科学版） 2020年41卷第4期页码：572-581
- 作者机构：
  
  中山大学附属第一医院病理科，广东广州 510080
- 作者简介：
  
  缪娜波，硕士研究生，研究方向：淋巴瘤病理，E-mail: 994212891@qq.com
- 基金信息：
  
  国家自然科学基金(81872175);广东省科技创新战略专项资金(2018A030313361)
- DOI：
  中图分类号： R733.4
- 纸质出版日期：2020-07-15，
  
  收稿日期：2020-02-29，
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缪娜波,黎绮铭,李淑华等.p-AXL与c-MYC和/或BCL-2共表达在弥漫大B细胞性淋巴瘤中的临床意义[J].中山大学学报（医学科学版）,2020,41(04):572-581.

MIAO Na-bo,LI Qi-ming,LI Shu-hua,et al.Clinical Significance of Expression of p-AXL and Co-expression with c-MYC and/or BCL-2 in DLBCL[J].Journal of Sun Yat-sen University(Medical Sciences),2020,41(04):572-581.
缪娜波,黎绮铭,李淑华等.p-AXL与c-MYC和/或BCL-2共表达在弥漫大B细胞性淋巴瘤中的临床意义[J].中山大学学报（医学科学版）,2020,41(04):572-581. DOI：

MIAO Na-bo,LI Qi-ming,LI Shu-hua,et al.Clinical Significance of Expression of p-AXL and Co-expression with c-MYC and/or BCL-2 in DLBCL[J].Journal of Sun Yat-sen University(Medical Sciences),2020,41(04):572-581. DOI：

摘要

目的

探索磷酸化酪氨酸激酶p-AXL在弥漫大B细胞性淋巴瘤（DLBCL）中的表达情况及其临床病理意义，并进一步探讨p-AXL与c-MYC和/或BCL-2共表达的临床病理意义，及其与

MYC

断裂基因的临床病理联系。

方法

收集2012-2017年在中山大学附属第一医院确诊为DLBCL的病例118例，将入组的石蜡组织制作成组织芯片。免疫组化法检测DLBCL组织中p-AXL、c-MYC和BCL-2蛋白的表达；荧光原位杂交法（FISH）检测DLBCL组织中

MYC

断裂基因的表达情况。

结果

p-AXL蛋白在DLBCL肿瘤细胞的胞膜和/或胞质中表达；p-AXL表达与DLBCL化疗缓解呈显著性相关（

＜0.01），阳性患者化疗缓解率低于阴性患者；p-AXL表达与Hans分型显著性相关（

＜0.01），p-AXL多见于Non-GCB型；p-AXL与c-MYC、BCL-2及c-MYC/BCL-2蛋白表达均显著性相关（

＜0.01）。p-AXL/c-MYC、p-AXL/BCL-2、p-AXL/c-MYC/BCL-2蛋白共表达均与Hans分型显著性相关（

＜0.01），多见于Non-GCB型。p-AXL与患者无进展生存期(PFS)显著性相关，阳性者PFS低于阴性患者（

＜0.05）；p-AXL阳性者总生存期（OS）亦低于p-AXL阴性者，但差异未达统计学意义（

＞0.05）。单变量分析显示，男性且p-AXL阳性、Non-GCB型且p-AXL阳性、p-AXL/c-MYC、p-AXL/c-MYC/BCL-2蛋白共表达均是DLBCL患者PFS和OS降低的危险因素（

＜0.05）；但是，多变量分析显示，仅男性且p-AXL阳性、p-AXL/c-MYC蛋白共表达是DLBCL患者PFS和OS降低的显著性危险因素（

＜0.05

；P

＜0.01）。

结论

DLBCL中p-AXL与c-MYC和/或BCL-2的表达、Hans分型、肿瘤化疗缓解率降低和PFS缩短均显著性相关；p-AXL/c-MYC共表达、男性且p-AXL阳性均可作为DLBCL的独立性预后指标。

Abstract

Objective

To investigate the expression and significance of phosphorylated receptor tyrosine kinase（p-AXL）in diffuse large B cell lymphoma (DLBCL)

and the clinical value of its co-expression with BCL-2 and /or

c-MYC

split gene.

Methods

Totally 118 cases of DLBCL were collected in the First Affiliated Hospital of Sun Yat-sen University from 2012 to 2017，and prepared as tissue array. p-AXL

c-MYC and BCL-2 proteins were detected by immunohistochemistry

and c-MYC split gene was detected by FISH staining.

Results

p-AXL protein was stained on tumor cells’ membrane or in the cytoplasm of DLBCL cells. p-AXL was expressed more commonly in Non-GCB type than in GCB type. The expression of p-AXL was significantly correlated with the chemotherapy effect (

0.01)

and the expression of

c-MYC

split gene or BCL-2 protein separately (

0.01). Co-expression of p-AXL and c-MYC

or BCL-2

or both of them was significantly correlated with the Hans typing (

0.01). The PFS of p-AXL positive patients was obviously lower than that of p-AXL negative patients (

0.05). The OS of p-AXL positive patients was also lower than that of the negative patients

but the difference had no statistical significance (

0.05). Univariate analysis showed that p-AXL and male

p-AXL and Non-GCB type

p-AXL and c-MYC co-expression

p-AXL and c-MYC and/or BCL-2 co-expression were the risk factors for PFS and OS in DLBCL patients (

0.05). Multivariate analysis showed that p-AXL positive in male (

0.05) and p-AXL/c-MYC co-expression (

0.01) were independent risk factors for PFS and OS in DLBCL patients.

Conclusions

p-AXL protein is expressed in DLBCL

and its expression is significantly related to the expression of c-MYC and BCL-2. p-AXL expression is associated with lower chemotherapy response rate

shorter progression-free survival and shorter overall survival. p-AXL/c-MYC co-expression or p-AXL positive in male may be an independent prognostic factor for DLBCL patients.

关键词

弥漫大B细胞性淋巴瘤p-AXLB淋巴细胞瘤-2c-MYC预后

Keywords

DLBCLp-AXLBCL-2c-MYCprognosis

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