Objective: To investigate the predictive value of methyltransferase EZH2 expression level on the clinical efficacy and long-term prognosis of patients with primary gastrointestinal diffuse large B-cell lymphoma (PGI-DLBCL).
Methods: 161 patients with newly treated PGI-DLBCL in our hospital from August 2013 to July 2019 were selected. The expression level of EZH2 protein was detected by immunohistochemistry, and the short-term efficacy and long-term survival differences of patients with different levels of EZH2 were compared. The predictive values of EZH2 expression level on the short-term efficacy and long-term prognosis of PGI-DLBCL patients were analyzed by Log-rank test and COX risk proportional regression model. Chi-square test and Logistic regression analysis were used to analyze the influencing factors of EZH2 expression level.
Results: The complete response (CR) and overal response(OR) rates of those with high EZH2 expression were significantly lower than those with low EZH2 expression (P<0.001). The median OS and PFS of EZH2 high-level and low-level expression group was 37, 31 months and 49, 42 months, respectively. The cumulative OS and PFS rates of the high-level expression group were significantly lower than those of the low-level expression group, and the differences were statistically significant (P<0.05). The high expression levels of H3K27me3, EZH2, BCL-2, BCL-6, c-MYC were closely related to the shortening of OS and PFS, while the high expression level of Ki-67 was closely related to the shortening of OS (P<0.05), of which the high expression levels of H3K27me3, EZH2, BCL-2, and BCL-6 were independent risk factors for shortening of OS and PFS. The expression level of EZH2 was positively correlated with the expression level of H3K27me3, BCL-6, c-MYC and Ki-67 (r=0.741, r=0.837, r=0.809, r=0.772), and the high expression levels of H3K27me3, BCL-6 and Ki-67 were independent factors influencing the high expression of EZH2.
Conclusion: In patients with PGI-DLBCL, the high expression of EZH2 significantly reduces the short-term CR and OR rates, which is an independent risk factor for the shortening of long-term OS and PFS rates, and it is independently related to the high expression of H3K27me3 and BCL6.
题目: 甲基转移酶EZH2表达水平对原发性胃肠道弥漫大B细胞淋巴瘤患者临床疗效及远期预后的预测价值分析.
目的: 探讨甲基转移酶EZH2表达水平对原发性胃肠道弥漫大B细胞淋巴瘤（PGI-DLBCL）患者的临床疗效及远期预后的预测价值.
方法: 选择2013年8月-2019年7月本院161例初治的PGI-DLBCL患者，检测其EZH2蛋白表达水平，比较不同水平EZH2患者的近期疗效及远期生存差异；Log-rank检验及COX风险比例回归模型统计分析EZH2表达水平对PGI-DLBCL预后的预测价值；卡方检验及Logistic回归法分析EZH2表达水平的影响因素.
结果: EZH2高表达患者完全缓解率、总缓解率均明显低于低表达患者(P<0.001)。EZH2高、低水平表达组中位总生存期（OS）及无进展生存期（PFS）分别为37、31个月和49、42个月，高水平表达组累积OS和PFS率均明显低于低水平表达组，差异均有统计学意义（P<0.05）。H3K27me3、EZH2、BCL-2、BCL-6、c-MYC高表达与患者OS和PFS缩短密切相关，Ki-67高表达与患者OS缩短密切相关(P<0.05)，其中H3K27me3、EZH2、BCL-2、BCL-6高表达为患者OS和PFS缩短的独立危险因素。EZH2表达水平与H3K27me3、BCL-6、c-MYC、Ki-67表达水平均呈正相关(r=0.741，r=0.837，r=0.809，r=0.772)，其中H3K27me3、BCL-6、Ki-67高表达为EZH2高表达的独立影响因素.
结论: 在PGI-DLBCL患者中，EZH2高表达明显降低近期完全缓解率、总缓解率，是远期OS、PFS率缩短的独立危险因素，与H3K27me3、BCL-6高表达呈独立相关.