P53突变蛋白表达对弥漫大B细胞淋巴瘤预后的预测作用

 目的　探讨p53突变蛋白表达对弥漫大B细胞淋巴瘤（DLBCL）预后的预测作用，指导个体化治疗。方法　随机选择初治DLBCL患者62例，应用免疫组织化学方法检测p53突变蛋白和CD10、bcl-6、MUM1的表达，分析p53突变蛋白表达与患者临床特征、分子分型以及预后的关系。结果　48.4 %（30／62）的患者表达p53突变蛋白。p53突变蛋白表达与初始治疗反应有关（χ2＝20.365，P＝0.040），阳性组的完全缓解率为33.3 %（10／30），阴性组为59.4 %（19／21）；与分子分型有关（χ2＝31.023，P＝0.021），阳性组非生发中心型比例显著高于阴性组，分别为83.3 %和56.2 %；与其他临床特征无关。多因素生存分析显示p53突变蛋白表达是独立的预后预测因子，阳性组的无进展生存期和中位生存期均短于阴性组（χ2＝36.784，P＝0.005和χ2＝35.276，P＝0.006）。结论　p53突变蛋白表达是DLBCL独立的不良预后因子，能够用来指导个体化治疗。

Prognostic significance of p53 mutation protein in patients with diffuse large B-cell lymphoma

Objective To explore the prognostic significance of p53 mutation protein in patients with diffuse large B-cell lymphoma for the purpose of individualized therapy. Methods Newly diagnosed 62 cases were randomly chosen from our hospital, p53 mutation protein and CD10, bel-6, MUM1 were tested by immunohistoehemistry. Correlation of p53 mutation protein with patients＂ characteristics, genotype and survival were analysed in the study. Results p53 mutation protein was found in 48.4 % （30/62） of patients. Its expression was only related to initial treatment response （X^2=20.365, P =0.040）, including complete remission rate of 33.3 % （10/30） in positive group and 59.4 % （19/32） in negative group, and non-germinal center genotype （X^2=31.023, P =0.021） with 83.3 % in positive group and 56.2 % in negative group. No other correlation was not verified with clinical features. Multivariate survival analysis showed that p53 mutation protein was an independent predictor for shorter progress-free and overall survival in positive group （X^2= 30.784, P =0.005 and X^2 =35.276, P =0.006）. Conclusion p53 mutation protein should be an independent predictor with poor prognosis and to direct personalized therapy.