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目的探讨磷酸二酯酶4B(phosphdiesterase 4B,PDE4B)基因过表达对弥漫大B细胞淋巴瘤(diffuse large B-cell lymphoma,DLBCL)患者预后的影响,并分析其预后价值。方法从GEO(gene expression omnibus)数据库获得320例DLBCL患者的基因芯片数据,比较PDE4B基因过表达与正常表达患者生存率的差异。构建单变量国际预后指数(international prognostic index,IPI)、PDE4B和多变量(IPI+PDE4B)Cox比例风险模型,并用时点/动态受试者工作曲线(receiver operating characteristic curves,ROC)法分析模型的预测能力随时间的变化趋势,一致性统计量C用于评价和比较各模型的预测准确度。结果 PDE4B基因过表达的患者死亡的风险是正常表达的1.431倍(HR=1.431,95%CI:1.013~2.002,P=0.042)。多变量模型的C统计量与单变量模型相比,差异有统计学意义(IPI vs.IPI+PDE4B:Z=15.0,P<0.001;PDE4B vs.IPI+PDE4B:Z=53.7,P<0.001)。结论 PDE4B基因过表达是DLBCL患者预后的危险因素,结合IPI和PDE4B基因能提高DLBCL的预后准确性。
Objective To investigate the effect of phosphodiesterase 4B (PDE4B) gene overexpression on the prognosis of patients with diffuse large B-cell lymphoma (DLBCL) and to evaluate its prognostic value. Methods The gene chip data of 320 patients with DLBCL were obtained from GEO (gene expression omnibus) database. The differences of survival rate between PDE4B gene over-expression and normal expression were compared. To construct univariate Cox proportional hazards model of international prognostic index (IPI), PDE4B and multivariate (IPI + PDE4B), and to analyze the changes of model using the receiver operating characteristic curves (ROC) The trend of predictive ability over time, the consistency statistic C is used to evaluate and compare the prediction accuracy of each model. Results The risk of death from PDE4B overexpression was 1.431 times of normal expression (HR = 1.431, 95% CI: 1.013-2.002, P = 0.042). Compared with the univariate model, the C statistic of the multivariate model was statistically significant (IPI vs. IPI + PDE4B: Z = 15.0, P <0.001; PDE4B vs. IPI + PDE4B: Z = 53.7, P <0.001) . Conclusion PDE4B overexpression is a risk factor for prognosis in patients with DLBCL. The combination of IPI and PDE4B can improve the accuracy of DLBCL prognosis.