MYC在弥漫大B细胞淋巴瘤的表达及其临床意义

目的 探讨MYC在弥漫大B细胞淋巴瘤（diffuse large B-cell lymphoma，DLBCL）中的表达及其与预后的关系。方法 回顾性分析广西医科大学附属肿瘤医院2011年2月至2018年8月收治的220例弥漫大B细胞淋巴瘤患者的临床资料。采用免疫组织化学法检测MYC蛋白在DLBCL组织中的表达，并分析其与患者临床病理特征及预后的关系。检索GEO（gene expression omnibus）数据库中有生存资料和基因表达数据的DLBCL数据集，分析MYC基因表达与预后的关系。结果 220例DLBCL组织中MYC蛋白阳性表达率为18.64%，MYC蛋白表达阳性患者总生存期（overall survival，OS）及无进展生存期（progress-free survival，PFS）较阴性表达患者明显缩短（P＜0.001）。亚组分析显示，在GCB免疫亚型中，MYC蛋白表达阳性患者较阴性患者OS明显缩短（P＜0.001）；在non-GCB免疫亚型中，MYC蛋白表达阳性患者较阴性患者的OS及PFS明显缩短（P＜0.001）。Cox比例风险回归模型分析结果显示，MYC蛋白阳性表达是影响DLBCL患者预后的独立危险因素（P<0.01）。GEO数据库中数据集GSE10846分析结果显示MYC基因高表达患者OS明显著缩短（P＜0.01）。结论 MYC蛋白阳性表达的DLBCL患者预后较差。

Expression of MYC in diffuse large B-cell lymphoma and its clinical significance

Objective To explore the expression of MYC in diffuse large B-cell lymphoma （DLBCL） and its relationship with the prognosis of DLBCL. Methods The clinical data of 220 patients with DLBCL admitted to Guangxi Medical University Cancer Hospital from February 2011 to August 2018 were retrospectively analyzed. The expression of MYC protein was detected by immunohistochemistry，and to analyze the correlations of MYC protein with clinical pathological characteristics and prognosis. Datasets containing the survival data and gene expression data about DLBCL were collected by searching Gene Expression Omnibus（GEO） to analyze the expression of MYC gene and its relationship with prognosis. Results The positive rate of MYC protein expression in 220 cases of DLBCL tissues was 18.64%. The overall survival（OS） and progress-free survival （PFS） of patients with positive MYC protein expression were significantly shorter than those with negative MYC protein expression（P<0.001）. Subgroup analysis indicated that in germinal center B-cell-like（GCB） subtype，the OS of patients with positive MYC protein expression were obviously shorter than that of patients with negative MYC protein expression，showing a statistically significant difference （P<0.001）. In non-GCB subtype，the OS and PFS of patients with positive MYC protein expression were shorter than those of patients with negative MYC protein expression，showing statistically significant differences（P<0.001）. The result of  Cox proportional hazard regression model analysis suggested that MYC protein expression was an independent risk factor for the prognosis of DLBCL patients（P<0.001）. GSE10846 dataset in GEO was analyzed，and the result con-firmed that the OS of patients with high MYC gene expression was evidently shortened （P<0.01）. Conclusion Patients with high MYC expression have a poor prognosis.