多发性骨髓瘤患者骨髓组织中NF-κB/p65的表达与硼替佐米疗效的关系-东南大学学报医学版

多发性骨髓瘤患者骨髓组织中NF-κB/p65的表达与硼替佐米疗效的关系

单位：1. 南京医科大学鼓楼临床医学院血液科, 江苏南京 210009;
2. 南京医科大学鼓楼临床医学院病理科, 江苏南京 210009

分类号：R733.3

出版年·卷·期（页码）：2016·35·第一期（41-45）

摘要：

目的:观察NF-κB/p65在初发的多发性骨髓瘤(multiple myeloma, MM)骨髓活检组织中的表达与患者临床特征及硼替佐米疗效的关系。方法:应用改良的甲基丙烯酸甲基酯单体塑料包埋法进行骨髓活检组织制片,采用免疫组化法分别检测59例初诊MM和10例正常对照骨髓活检组织中NF-κB/p65的表达情况,并分析NF-κB/p65与MM患者临床特征及疗效的关系。结果:(1) 59例MM患者中40.67%(24/59)NF-κB/p65高表达,对照组10例均为低表达,两组差异有统计学意义(P<0.05)。(2)在NF-κB/p65高表达患者中,含硼替佐米方案与不含硼替佐米方案疗效差异有统计学意义(88.9% vs 26.7%, P=0.02);但在NF-κB/p65低表达患者中,含硼替佐米方案与不含硼替佐米方案疗效差异无统计学意义(50% vs 23.8%, P=0.11)。结论:NF-κB/p65在MM骨髓组织中表达水平明显升高,NF-κB/p65高表达的MM患者使用含硼替佐米的方案疗效优于未含硼替佐米治疗者,MM患者骨髓组织NF-κB/p65表达水平可能成为预测硼替佐米治疗MM疗效的依据之一。

Objective:To explore NF-κB/p65 expression in the bone marrow of newly diagnosed multiple myeloma (MM) and the relationship between it and the overall response rate after treatment. Methods:The bone marrow sections were made from plastic(methyl-methacrylate)-embedded bone marrow biopsies. The NF-κB/p65 expression of MM group and control group were detected by EnVison immunohistochemistry. The clinical significance of NF-κB/p65 was analyzed. Results:NF-κB/p65 was highly expressed in 40.67%(24/59) MM bone marrow biopsies, expression of all 10 patients in the normal control group were low, there was significant difference between the two groups (P<0.05). In patients of highly NF-κB/p65 expressed,the treatment response rate showed statistically significant difference between groups treated with bortezomib and without bortezomib (88.9% vs 26.7%, P=0.02), but in patients with low expression of NF-κB/p65, the treatment response rate showed no significant difference in the two groups (50% vs 23.8%, P=0.11). Conclusion:The expression of NF-κB/p65 in MM bone marrow biopsies increases significantly. MM patients with high expression of NF-κB/p65 preferr the clinical benefit of bortezomib-based regimens. NF-κB/p65 expression level may form the basis for predicting the efficacy of bortezomib-based regimens.

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