p53 and bcl-2 expression in high-grade B-cell lymphomas: correlation with survival time.
p53 and bcl-2 expression in high-grade B-cell lymphomas: correlation with survival time.
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DOI：
10.1038/bjc.1994.61
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发表时间：
1994-02
影响因子：
8.8
通讯作者：
Pezella F [corrected to Pezzella, F ]
中科院分区：
文献类型：
--
作者：
Piris, M A;Pezzella, F;Martinez-Montero, J C;Orradre, J L;Villuendas, R;Sanchez-Beato, M;Cuena, R;Cruz, M A;Martinez, B;Pezella F [corrected to Pezzella, F ]
B细胞高级别淋巴瘤在组织学、临床表现、治疗反应和预后方面是异质性的。由于bcl-2和p53基因异常常与多种类型的淋巴系统恶性肿瘤有关，我们的目的是研究bcl-2和p53基因表达与119例B细胞高级别淋巴瘤患者生存率的关系。这些数据来自Virgen de la Salud Hospital，Toledo，Spain（73例）、John Radcliffe Hospital，Oxford，UK（31例）和Istituto Nazionale dei Tumori，Milan，意大利（15例）。bcl-2蛋白表达与生存率之间的关系很小，这取决于肿瘤的原发部位（粘膜淋巴结），与总生存率缺乏显著相关性。与此相反，在我们的系列中，p53表达与生存概率相关，这种关系既显着又独立于组织学诊断。p53阳性患者在诊断后的头几个月内表现出预期寿命的突然下降。多因素回归分析证实，与生存率显著相关的唯一参数是结节起源，这与较好的预后相关，p53表达，这表明预后不良。bcl-2和p53同时表达与p53单独表达相比，预后较差。这对于存在于淋巴结中的大B细胞淋巴瘤特别重要。p53和bcl-2在大B细胞淋巴瘤中的累积不良效应，在淋巴结肿瘤中更为显著，可以证实非霍奇金淋巴瘤中存在多步遗传失调。这表明控制细胞凋亡及其失调的遗传机制是淋巴瘤进展中的关键步骤。
B-cell high-grade lymphomas are heterogeneous in terms of histology, clinical presentation, treatment response and prognosis. As bcl-2 and p53 gene deregulations are frequently involved in several types of lymphoid malignancies, we aimed our investigation at the study of the relation between bcl-2 and p53 expression and survival probability in a group of 119 patients with B-cell high-grade lymphoma. These were obtained from the Virgen de la Salud Hospital, Toledo, Spain (73 cases), John Radcliffe Hospital, Oxford, UK (31 cases), and the Istituto Nazionale dei Tumori, Milan, Italy (15 cases). The relation between bcl-2 protein expression and survival was small, depending on the primary localisation of the tumour (in lymph node of mucosae), and lacked a significant correlation with overall survival. In contrast with this, p53 expression was related to survival probability in our series, this relation being both significant and independent of histological diagnosis. p53-positive patients showed a sudden decrease in life expectancy in the first months after diagnosis. Multivariant regression analysis confirmed that the only parameters significantly related with survival were extranodal origin, which is associated with a better prognosis, and p53 expression, which indicates a poor prognosis. Simultaneous expression of bcl-2 and p53 was associated with a poorer prognosis than p53 alone. This is particularly significant for large B-cell lymphomas presenting in lymph nodes. The cumulative poor effect of both p53 and bcl-2 in large B-cell lymphomas, which is more significant in nodal tumours, could confirm the existence of a multistep genetic deregulation in non-Hodgkin's lymphoma. This indicates that the genetic mechanisms controlling apoptosis and their disregulation are critical steps in the progression of lymphomas.