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目的研究外周T细胞淋巴瘤(peripheral T-cell lymphomas,PTCLs)APE1和P53蛋白联合表达与临床特征、化疗效果及预后的关系。方法免疫组化法检测178例PTCLs患者瘤细胞APE1和P53蛋白表达情况,采用单因素和多因素分析比较APE1和P53蛋白表达及联合表达与临床特征、预后的关系。结果PTCLs患者APE1和P53蛋白表达阳性率分别为82.6%(147/178)和40.5%(72/178),其中血管免疫母T细胞淋巴瘤(ATL)和外周T细胞淋巴瘤-非特异型(PTCL-U)患者的APE1表达阳性率显著高于结外NK/T细胞淋巴瘤(NK/TL)、皮下脂膜炎样T细胞淋巴瘤(CTCL)和间变大T细胞淋巴瘤(ALCL)患者(P<0.05)。具有APE1+/P53+共表达患者的临床分期以Ⅲ+Ⅳ为主,中、高危患者比例高;APE1+/P53-组与APE1+/P53+组患者化疗疗效显著低于APE1-/P53-组和APE1-/P53+组(P<0.01);APE1+/P53-组和APE1+/P53+组患者总生存率明显低于APE1-/P53-和APE1-/P53+2组(P<0.01),APE1+/P53+组患者无病生存时间(DFS)明显低于其他3组(P<0.01);单因素生存分析显示APE1及P53呈阳性表达、APE1+/P53-和APE1+/P53+联合表达与患者预后不良有关(P<0.05),APE1+/P53-和APE1+/P53+联合表达均与3年生存率有关(P<0.05,P<0.01);多因素生存分析显示APE1+/P53+共表达患者预后最差(P<0.01)。结论APE1、P53表达阳性,以及APE1+/P53-、APE1+/P53+联合表达的患者预后不良;APE1+/P53+共表达为PTCLs患者独立预后因素。
Objective To study the relationship between APE1 and P53 protein expression in peripheral T-cell lymphomas (PTCLs) and their clinical characteristics, chemotherapeutic effect and prognosis. Methods The expressions of APE1 and P53 protein in 178 cases of PTCLs were detected by immunohistochemistry. The relationship between APE1 and P53 protein expression and clinical features and prognosis was analyzed by univariate and multivariate analysis. Results The positive rates of APE1 and P53 protein in PTCLs were 82.6% (147/178) and 40.5% (72/178), respectively. The positive rates of ATL and T-lymphocyte-nonspecific The positive rates of APE1 expression in PTCL-U patients were significantly higher than those in patients with extranodal NK / T cell lymphoma (NK / TL), subcutaneous panniculitis-like T cell lymphoma (CTCL) and metamerism large T cell lymphoma (ALCL) Patients (P <0.05). The patients with APE1 + / P53 + co-expression had the highest clinical stage Ⅲ + Ⅳ, and the high-risk patients with high APE1 + / P53- and APE1 + / P53 + patients had significantly lower rates of chemotherapy than APE1- / P53- and APE1- / P53 + group (P <0.01). The overall survival rate of APE1 + / P53- and APE1 + / P53 + group was significantly lower than that of APE1- / P53- and APE1- / P53 + 2 group (P <0.01) The survival time (DFS) of patients was significantly lower than that of the other three groups (P <0.01). Univariate survival analysis showed that the expression of APE1 and P53 were positive. The combined expression of APE1 + / P53- and APE1 + / P53 + was associated with poor prognosis (P < , APE1 + / P53- and APE1 + / P53 + expression were associated with 3-year survival rate (P <0.05, P <0.01). Multivariate survival analysis showed that APE1 + / P53 + co-expression had the poorest prognosis (P <0.01). Conclusions APE1, P53 expression is positive, and the APE1 + / P53-, APE1 + / P53 + co-expression in patients with poor prognosis; APE1 + / P53 co-expression of PTCLs patients with independent prognostic factors.