Beclin 1 expression predicts favorable clinical outcome in patients with diffuse large B-cell lymphoma treated with R-CHOP
Beclin 1 expression predicts favorable clinical outcome in patients with diffuse large B-cell lymphoma treated with R-CHOP
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Beclin 1 表达预测接受 R-CHOP 治疗的弥漫性大 B 细胞淋巴瘤患者的良好临床结果
DOI：
10.1016/j.humpath.2010.12.014
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发表时间：
2011-10-01
期刊：
影响因子：
3.3
通讯作者：
Li, Zhi-Ming
中科院分区：
文献类型：
--
作者：
Huang, Jia-Jia;Zhu, Ying-Jie;Li, Zhi-Ming
Beclin 1不仅在自噬中起关键作用，而且在凋亡和分化中起关键作用。Beclin 1在弥漫性大B细胞淋巴瘤中的预后意义在很大程度上尚未探讨。分析2003年至2007年接受利妥昔单抗联合环磷酰胺、多柔比星、长春新碱和泼尼松方案治疗的118例新诊断弥漫性大B细胞淋巴瘤患者肿瘤标本中beclin I的免疫组织化学蛋白表达。Beclin 1在101例（85.6%）患者中观察到表达。低beclin I表达与B症状（P = 0.018）、晚期安阿伯分期（P = 0.009）、国际预后指数≥ 2（P = 0.049）、血清乳酸脱氢酶水平升高（P = 0.037）和使用修订的国际预后指数模型的不良结局（P = 0.013）相关。标准治疗后，高beclin 1表达患者的完全缓解率高于低beclin 1表达患者（77.5% vs 55.3%，P = 0.013）。Beclin 1表达与bcl-2表达呈负相关（P = 0.019），与较长的总生存期（P = 0.035）和无进展生存期（P = 0.013）呈正相关。在多变量分析中，beclin 1表达和修订的国际预后指数模型独立预测生存。提出的临床病理预后模型包括这2个独立的预后因素，可以将患者分为3个风险组（分别P < .0001）。Beclin I表达预测标准治疗弥漫性大B细胞淋巴瘤患者的上级临床结局将弥漫性大B细胞淋巴瘤患者分为不同风险类别的新预后模型可能有助于指导治疗计划。(C)2011 Elsevier Inc. All rights reserved.
Beclin 1 plays a critical role not only in autophagy, but also in apoptosis and differentiation. The prognostic significance of beclin 1 in diffuse large B-cell lymphoma is largely unexplored. Immunohistochemical protein expression of beclin I in 118 tumor specimens from patients newly diagnosed with diffuse large B-cell lymphoma treated with rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone regimen from 2003 to 2007 was analyzed. Beclin 1 expression was observed in 101 (85.6%) patients. Low beclin I expression was related to B symptoms (P = .018), advanced Ann Arbor stage (P = .009), International Prognostic Index of 2 or higher (P = .049), elevated serum lactate dehydrogenase level (P = .037), and poor outcome using the revised International Prognostic Index model (P = .013). The complete remission rate after standard treatment was higher in patients with high beclin 1 expression than in those with low beclin 1 expression (77.5% versus 55.3%, P = .013). Beclin 1 expression was inversely associated with bcl-2 expression (P = .019) and positively associated with longer overall survival (P = .035) and progression-free survival (P = .013). In multivariate analysis, beclin 1 expression and the revised International Prognostic Index model independently predicted survival. The proposed clinicopathologic prognostic model including these 2 independent prognostic factors allowed classification of patients into 3 risk groups (P < .0001, respectively). Beclin I expression predicts superior clinical outcome in patients with diffuse large B-cell lymphoma treated with standard treatment. The novel prognostic model which divides patients with diffuse large B-cell lymphoma into different risk categories may help guide treatment planning. (C) 2011 Elsevier Inc. All rights reserved.