The Expression And Clinical Significance Of BAX And BCL-2 In Diffuse Large B Cell Lymphoma

OBJECTIVE: Diffuse large B cell lymphoma(DLBCL)is a common highly invasive non-Hodgkin lymphoma(NHL).With the widespread use of molecularly targeted drugs,autologous stem cell transplantation,etc.,the cure rate and survival time of DLBCL are prolonged,but 30%-40% of patients still die due to primary resistance or recurrence.The cells not only undergo abnormal proliferation during tumor development,but also their apoptosis ability.Apoptosis-related genes play an important role in apoptosis.The BCL-2 family gene is an apoptosis-related gene with an important role,and its expression product BCL-2 family proteins are classified into two types according to their roles in apoptosis.BAX and BCL-2 are important proteins that play a pro-apoptotic and anti-apoptotic role in the BCL-2 family.The aim of this study was to detect the expression characteristics of BAX and BCL-2 proteins in pathological specimens of patients with DLBCL,and to analyze the relationship between BAX and BCL-2 and clinicopathological features,and to explore its prognostic value.METHODS: The clinical and pathological data and paraffin-embedded pathological specimens of 68 patients with newly diagnosed DLBCL who were admitted to Liao Ning Cancer Hospital from December 2011 to May 2016 were collected.The expression of BAX and BCL-2 proteins in tumor cells were detected by immunohistochemistry.To study the relationship between BAX,BCL-2 and the clinical pathological features of DLBCL.The clinical efficacy and survival data of 64 patients with(R)-CHOP-like chemotherapy were analyzed.The differences and correlations between clinical indicators were analyzed by chi-square test.The relationship between Bax and Bcl-2 and clinical efficacy was discussed..Survival analysis was performed by Kaplan-Meier method,and single-factor and multi-factor analysis was performed by log-rank test and COX proportional hazard regression model.P < 0.05 was considered statistically significant.RESULTS: 1.BAX is expressed more frequently in the cytoplasm of DLBCL cells.BAX was positive in 46 cases(67.6%)and BAX was negative in 22 cases(32.4%).BCL-2 is mainly expressed in the cytoplasm of DLBCL cells.BCL-2 was positive in 38 cases(55.9%)and BCL-2 was negative in 30 cases(44.1%).BAX and BCL-2 were positive in 24 cases(35.3%),BAX and BCL-2 were negative in 8 cases(11.8%),BAX-negative/BCL-2-positive in 14 cases(20.6%),BAX-positive/BCL-2negative in 22 cases(32.4%).There was no significant correlation between BCL-2expression and BAX expression.2.There was no significant correlation between BAX positive expression and age,gender,lesion location,stage,IPI score,LDH,group Bsymptoms,pathological type,and whether rituximab was used in DLBCL.0.05).The positive rate of BCL-2 in the primary node was significantly higher than that in the primary node(P<0.05).The BCL-2 positive rate of the IPI score of 0-2 was lower than the IPI score of >2(P<0.05).There was no significant correlation between BCL-2positive expression and clinical features such as age,gender,ECOG score,LDH,group B symptoms,pathological type,and whether rituximab was applied(P>0.05).3.In 64 patients with DLBCL who received chemotherapy with(R)-CHOP-like regimen,BAX positive expression was significantly associated with short-term efficacy(P<0.05).Univariate analysis showed that BAX expression,whether rituximab was applied,and LDH were significantly associated with OS,both of which were important factors influencing survival.At the same time,the pathological subtype,ECOG physical score has a certain influence on the prognosis.BCL-2 expression,age,gender,whether it was primary or not,group B symptoms,IPI scores,staging,etc.have nothing to do with survival.Multivariate analysis showed that the use of rituximab and LDH were independent factors in the prognosis of DLBCL.CONCLUSION: 1.There were different degrees of BAX and BCL-2 expression in the cytoplasm of DLBCL tumor cells,and there was no significant correlation between the expression of BAX and BCL-2.2.In DLBCL,BCL-2 may be related to the pathogenesis and malignancy of DLBCL in the primary node.BCL-2 may be used as an indicator to judge the poor prognosis of DLBCL.3,in DLBCL,BAX positive expression has a long survival period,suggesting that BAX is an important predictor ofprognosis.Whether rituximab or LDH is used is an independent factor affecting the prognosis of DLBCL.