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本研究探讨78例非霍奇金淋巴瘤BCL-XL表达和突变的发生率及其临床意义。应用激光微切割技术从淋巴结组织中特异地分离淋巴瘤细胞,用实时定量RT-PCR法检测淋巴瘤组织和淋巴瘤细胞中BCL-XL的表达,PCR直接测序法检测BCL-XL的突变情况。结果表明:与淋巴结反应性增生(15例)相比,滤泡性淋巴瘤(30例)组织和微切割的淋巴瘤细胞均高表达BCL-XL(P值分别为0.0064和<0.0001),而T细胞淋巴瘤(24例)和弥漫性大B细胞淋巴瘤(24例)中BCL-XL表达无明显升高。在滤泡性淋巴瘤中,BCL-XL高表达的患者常伴多个淋巴结外器官累及(P=0.0004),血清乳酸脱氢酶水平升高(P=0.0019),国际预后指数分组多为高危组(P=0.0013),患者总生存期短(P=0.0451)。突变检测发现1例滤泡性淋巴瘤BCL-XL的同义突变(密码子109ACA→ACC)。结论:BCL-XL表达与滤泡性淋巴瘤的疾病进展和患者预后密切相关。
This study was to investigate the incidence and clinical significance of BCL-XL expression and mutation in 78 cases of non-Hodgkin’s lymphoma. Lymphoma cells were isolated from lymph node tissues by laser microdissection. BCL-XL expression in lymphoma tissues and lymphoma cells was detected by real-time quantitative RT-PCR. The mutation of BCL-XL was detected by PCR direct sequencing. The results showed that BCL-XL was highly expressed in both follicular lymphoma (30 cases) and microdissected lymphoma cells (P = 0.0064 and <0.0001, respectively), compared with reactive lymph node hyperplasia (15 cases) There was no significant increase in BCL-XL expression in T-cell lymphoma (24 cases) and diffuse large B-cell lymphoma (24 cases). In follicular lymphoma, patients with high BCL-XL expression were often associated with multiple extranodal lymph nodes (P = 0.0004), elevated serum lactate dehydrogenase (P = 0.0019), and more often with the International Prognostic Index Group (P = 0.0013), the overall survival was short (P = 0.0451). Mutations detected a synonymous mutation in the follicular lymphoma BCL-XL (codon 109ACA → ACC). Conclusion: The expression of BCL-XL is closely related to the disease progression and the prognosis of patients with follicular lymphoma.