| Objective:To investigate the expression and the prognosis of Fas,FasL,Bcl-2,Survivin in the different subdivion of diffuse large B cell lymphoma and to explore the function and relation in DLBCLMethods:(1)DLBCL group is211cases and contrast group have10cases of LRFH,5cases of SLL,19cases of FL.(2)DLBCL was divided into germinal center-like(GCB) and non-germinal center-like(non-GCB) by CD10,Bcl-6,MUM1.(3) SP immunohistochemical method was performed to detect expression of Fas,FasL,Bcl-2,Survivin,Ki-67;(4)The apoptosis tumor cells were detected by TUNEL technique.(5)To analyse the final data by SPSS13.0software.Results:(1) The clinical features:in DLBCL, age range is3～82years,the median age is51years old;male have124cases,female have87cases,male:female is1.4:1;(2) DLBCL immune subdivions:according to CD10,Bcl-6,MUMl,211patients were divided into DLBCL GCB41cases(19.4%), non-GCB170cases(80.6%);(3) Express distribution:Fas is positive expression in cell membrane and (or) cell plasma, in DLBCL (76.8%) lower than FL (100.0%) have difference (P<0.05),in non-GCB(77.1%) and GCB(75.6%) have no difference (P>0.05); FasL is positive expression in cell plasma, in DLBCL (84.8%) higher than LRFH (50.0%) have difference (P<0.05), in non-GCB (85.9%) and GCB (80.5%) have no difference (P>0.05); Bcl-2is positive expression in cell plasma and (or) cell membranes, and in the DLBCL positive rate was61.1%,higher than LRFH(0%), lower than FL(84.2%) have difference (P<0.05), in non-GCB (63.5%) higher than GCB (51.2%) have no difference (P>0.05); Survivin is positive expression in the nucleus and (or) cell plasma, in DLBCL (74.9%) higher than LRFH (0.0%), SLL (20.0%), FL (31.6%) have difference (P<0.05), in non-GCB (75.3%) and GCB (73.2%) have no difference (P>0.05); compared to FL and SLL, PI and AI in the DLBCL have difference (P<0.05); PI, AI in GCB lower than non-GCB group have difference (P<0.05);(4) Correlation:after Spearman rank related inspection, Fas and Bcl-2, Survivin, PI, AI is obviously negative correlation, Bcl-2, Survivin and PI, AI is obviously positive correlation (P=0.000), PI and AI is positive correlation FasL and Survivin,and PI,AI have not significant correlation (P>0.05);(5) Clinical parameters:in DLBCL, PI,AI,Fas,FasL, Survivin, Bcl-2expression and age, clinical stages, IPI index, LDH level, transfer number, systemic symptom clinical parameters were not significantly relationship (P>0.05);(6)Prognosis:Through follow-up and statistical analysis we found that age, different parts, IPI index, and the number of transfer is risk factors of DLBCL (P<0.05). The patients GCB and with Fas, FasL expression, with Survivin, Bcl-2not expression had longer survival time. Conclusion:l.Apoptosis related proteins high expression of Bcl-2, Survivin and low expression of Fas in diffuse large B cell lymphoma common phenomenon for lymphoma occurrence and development have important sense.2.Fas and Bcl-2,Survivin correlation between the differences reflected in the local DLBCL two immunological subtypes:in GCB subtypes and they have negative correlation,suggesting that Fas expression may be inhibited Bcl-2,Survivin expression and effects of the tumor proliferation and apoptosis;while in the non-GCB subtype does not see this correlation,likely because of the type in the presence of more complex genetic abnormalities that made the Bcl-2,Survivin expression out of control.3.non-GCB and Fas protein negative,FasL protein negative;Bcl-2Survivin protein positive had shorter survival time, can be independent of clinical parameters as judged by the prognosis of DLBCL helper factor. |
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