Expression And Significance Of GCET1 And LMO2 In Diffuse Large B Cell Lymphoma

Objective: This study was analyze the expression of GCET1 and LMO2 protein in diffuse large B cell lymphoma(DLBCL)patients and to search for the proteins related to the clinical characteristics and prognosis,and to preliminarily explored the prognostic value of the biological marker-combined prognostic factors in DLBCL patients.Method: The clinical data of 137 patients who were first diagnosed with DLBCL in the First Affiliated Hospital of Nanchang University from January 2014 and March 2018 was collected.The expression of GCET1 and LMO2 was assessed by immunohistochemistry.The SPSS software was used to analyze the correlations of GCET1 and LMO2 protein with clinical pathological characteristics and prognosis.International Prognostic Index(IPI)and National comprehensive cancer network-IPI(NCCN-IPI)were used to predict survival of DLBCL patients,and to evaluate whether the addition of biological markers to the IPI and NCCN-IPI would enhance prognostic capacity.Result: 1.Among 137 patients,there were 74 males and 63 females,the median age was 58(27-87)years.The positive rate of GCET1 and LMO2 protein expression in 137 cases of DLBCL tissues was 26.3% and 16.8%.The following features were significantly associated with GCET1 protein expression: Ann Arbor stage(P=0.011),IPI(P=0.005),age-combined International Prognostic Index(P=0.023),laboratory parameters platelet(P=0.019).The following features were significantly associated with LMO2 protein expression: short-term effect(P = 0.005),B symptoms(P =0.042).2.With a median follow-up time of 44.2(21.5-71.5)months,there were no significant difference of overall survival(OS)and progress-free survival(PFS)between positive GCET1 protein expression and negative GCET1 protein expression groups(3-year OS: 80.6% vs 70.3%,P>0.05;3-year PFS: 66.7% vs 58.4%,P>0.05).The OS of patients with positive LMO2 protein expression significantly longer than those with negative LMO2 protein expression(3-year OS: 91.3% vs 69.3%,P=0.028),though the expression of LMO2 was not associated with PFS(3-year PFS: 73.9% vs 57.9%,P>0.05).3.The result of Cox proportional hazard regression model analysis suggested that IPI>2,ECOG?2 and consortium regimen without rituximab were independent risk factors for the prognosis of DLBCL patients that affected the OS.That ECOG?2,short-term effect below CRu and consortium regimen without rituximab were independent risk factors for the prognosis of DLBCL patients that affected the PFS.4.For the low risk/low-intermediate risk patients performed by NCCN-IPI,the OS of patients with positive GCET1 protein expression significantly longer than those with negative GCET1 protein expression(3-year OS: 100% vs 81.5%,P=0.022),though the expression of GCET1 was not associated with PFS(3-year PFS: 79.2% vs 72.2%,P>0.05).For the patients with positive BCL6 protein expression,the OS of patients with positive GCET1 protein expression significantly longer than those with negative GCET1 protein expression(3-year OS: 88.9% vs 68.1%,P=0.039),though the expression of GCET1 was not associated with PFS(3-year PFS: 74.1% vs 61.1%,P>0.05).5.The addition of biological markers to the IPI and NCCN-IPI could enhance prognostic capacity in varying degree.Biological marker-combined IPI could identify the subset of DLBCL patients with low risk,low-intermediate risk,intermediate-high risk and high risk(P < 0.001).Although biological marker-combined NCCN-IPI could not identify the high risk patients,it could identify the subset of DLBCL patients with low risk,low-intermediate risk and intermediate-high risk(P<0.001).The first model is more powerful than the next.Conclusion: 1.The expression of GCET1 and LMO2 in DLBCL is associated with some prognostic factors.GCET1 and LMO2 protein may be good prognostic factors in DLBCL.2.Patients with IPI>2,ECOG?2,and consortium regimen without rituximab had poor prognosis.Patients with ECOG?2,Short-term effect below CRu and consortium regimen without rituximab were more likely progress.3.Biological marker-combined IPI is a powerful model in predicting prognosis.