Bcl-2与Bcl-6在弥漫性大B细胞淋巴瘤中的表达及意义

目的探讨Bcl-2和Bcl-6在弥漫性大B细胞淋巴瘤(diffuse large B cell lymphoma，DLBCL)中的表达及意义。方法收集46例2004年1月～2014年6月经行淋巴结活检初诊的DLBCL病例及病理资料，采用免疫组化方法检测DLBCL患者组织中Bcl-2及Bcl-6的表达情况，分析二者免疫组化指标与DLBCL临床特征及预后的关系。结果①46例DLBCL中行Bcl-2检测，阳性表达率为63.04%(29/46例)，行Bcl-6检测，阳性表达率为73.91%(34/46例)。②Bcl-2和Bcl-6表达与患者性别、年龄、有无全身症状、有无结外侵犯及PS评分无关(P>0.05)，而与临床分期和IPI评分呈正相关(P<0.05)。③Bcl-2和Bcl-6表达阳性患者其近期疗效和预后(总体生存期和无进展生存期)显著低于阴性患者，组间差异有统计学意义(P<0.05)。结论Bcl-2和Bcl-6阳性表达提示近期疗效与预后不佳，其水平可被视为独立的DLBCL分析因素，对患者治疗过程中病情发展的预测、个体化治疗策略的制定有重要意义。

Expression and Significance of Bcl-2 and Bcl-6 in Diffuse Large B-cell Lymphoma

ObjectiveTo investigate the expression and significance of Bcl-2 and Bcl-6 in diffuse large B-cell lymphoma (diffuse large B cell lymphoma，DLBCL)．MethodsThe expressions of Bcl-2 and Bcl-6 of 46 inpatients，who first diagnosed DLBCL based on lymph node biopsy between January 2004 and June 2014，were detected by immunohistochemistry，and the data were analyzed about the relationship of clinical features and prognosis of the patients．Results①The Bcl-2 expression rate was 63.04% (29/46)，the Bcl-6 expression rate was 73.91% (34/46)．②There was no relationship between the expression of Bcl-2 and Bcl-6 and the following factors，including gender，age，systemic symptoms， invasion of extra nodal and PS score (P>0.05)，but there was positive correlation between the expression of Bcl-2 and Bcl-6 and clinical stage and IPI score (P<0.05)．③The recently efficacy and prognosis (overall survival and progression-free survival) of patients，who with the expression of Bcl-2 and Bcl-6，were significantly lower than the patients who without expression of Bcl-2 and Bcl-6 (P<0.05)．ConclusionThe recently efficacy and prognosis of patients are poor， who with the expression of Bcl-2 and Bcl-6，the expression level of Bcl-2 and Bcl-6 can be regarded as an independent prognostic factor of DLBCL．It has significance for prediction of disease development and individualized treatment of patients．