【摘要】 目的:探讨T-LBL/ALL患者病变组织CD分子、MPO、Ki-67和C-MYC阳性比例及C-MYC在预测预后中的价值。方法:选取本院收治的T-LBL/ALL患者90例为T-LBL/ALL组及30例淋巴结反应性增生作为对照组。对2组患者进行免疫组织化学染色检测CD分子、MPO、Ki-67和C-MYC阳性比例及应用荧光原位杂交检测C-MYC基因的改变情况。结果:在90例T-LBL/ALL患者中,CD1a~+34例(37.8%),CD3·+67例(74.4%),εCD3~+47例(52.2%),CD7~+85例(94.4%),CD10~+33例(36.7%),CD34~+22例(24.4%),CD43~+48例(53.3%),CD45RO~+46例(51.1%),CD99~+88例(97.8%),TDT~+85例(94.4%),CD23、CD20、MPO均为阴性,Ki-67>80%47例(52.2%),Ki-67≤80%43例(47.8%)。在T-LBL/ALL组90例患者中,C-M YC蛋白阳性率为66.7%,明显高于对照组(阳性率为0)(P<0.05);C-MYC阳性率与T-LBL/ALL患者的Ki-67阳性指数、纵膈增宽呈正相关(r=0.567,r=0.532,P<0.05)。C-MYC蛋白阴性患者的1年总生存率(44.0%)明显高于C-MYC蛋白阳性患者(15.0%),C-MYC蛋白阴性患者总体生存率明显高于C-MYC阳性患者(P<0.05)。T-LBL/ALL患者的Ann Arbor分期、LDH、骨髓累及、纵膈增宽、Ki-67阳性指数、C-M YC蛋白表达与C-MYC基因断裂及拷贝数增加均无相关性(P>0.05)。结论:C-MYC蛋白阳性的患者总体生存率降低,与Ki-67阳性指数、纵膈增宽呈正相关,提示C-MYC蛋白表达的患者预后较差。更多还原

【Abstract】 Objective: To explore the value of of CD,MPO,Ki-67,C-MYC positive rates in the pathological tissues and C-MYC gene of patients with T-LBL/ALL for predicting Prognosis. Methods: Ninty cases of T-LBL/ALL patients in our hospital were selected and included in the T-LBL/ALL group,and 30 cases of lymphnode reactive hyperplasia were selected as control group. Immunohistochemical staining was used to detect the changes of CD,MPO,Ki-67 and C-MYC positive rate in 2 groups,and the changes of C-MYC gene were detected by fluorescence in situ hybridization. Results: In 90 patients with T-LBL/ALL,there were CD1 a~+34 cases( 37. 8%),CD3~+67 cases( 74. 4%),epsilon CD3~+47 cases( 52. 2%),CD7~+85 cases( 94. 4%),CD10~+33 cases( 36. 7%),CD34~+22 cases( 24. 4%),CD43~+48 cases( 53. 3%),CD45 RO~+46 cases( 51. 1%),CD99~+88 cases( 97. 8%),TDT~+85 cases( 94. 4%); and CD23,CD20,and MPO all were negative; Ki-67 > 80% 47 cases( 52. 2% cases),Ki-67≤80%,43 cases( 47. 8%). In 90 T-LBL/ALL patients,the positive rate of C-MYC( 66. 7%) was significantly higher than the control group( positive rate 0. 0%)( P < 0. 05); the Ki-67 index,mediastinal widening of T-LBL/ALL patients and the positive rate of C-MYC positively were correlated( P < 0. 05). The overall survival rate( 44. 0%) of C-MYC negative patients was significantly higher than that of C-MYC positive patients( 0. 0%). The overall survival rate of CMYC negative patients was significantly higher than that of C-MYC positive patients( P < 0. 05). Ann Arbor staging,LDH,bone marrowinvolvement,mediastinal widening,Ki-67 positive index,and C-MYC protein expression of patients with T-LBL/ALL did not correlated with increased C-MYC gene breakage and copy number( P > 0. 05). Conclusion:The overall survival rate of C-MYC positive patients decreases,which positively correlates with Ki-67 positive index and mediastinal width,suggesting that the prognosis of the patients with C-MYC protein expression is poorer.更多还原