GAS1、IL-1RAP、PRF1在ALK阳性间变性大细胞淋巴瘤患者中的表达及其临床意义

OBJECTIVE: To investigate the expressions of growth arrest-specific protein (GAS1), IL-1 receptor accessory protein (IL-1RAP) and perforin (PRF1) in patients with anaplastic lymphoma kinase positive, anaplastic large cell lymphoma (ALK(+) ALCL) and their relationships with clinical significances and the prognoses of ALK(+) ALCL. METHODS: Twenty-six formalin-fixed paraffin-embedded (FFPE) samples of ALK(+) ALCL patients who were diagnosed from January 2011 to September 2016 were collected. Twelve FFPE samples of patients with ALK(+) ALCL, 13 FFPE samples of patients with peripheral T cell lymphoma (not otherwise specified) (PTCL-NOS) and 8 FFPE samples of patients with angioimmunoblastic T-cell lymphoma (AITL) were used as control groups. RQ-PCR and immunohisto-chemical staining were used to detect the mRNA and protein expressions of GAS1, IL-1RAP and PRF1. The clinical data were analyzed. RESULTS: ①The expression levels of GAS1, IL-1RAP and PRF1 gene and protein in ALK(+) ALCL group were higher than those of the control groups (P<0.05), but the expression levels had no statistically significant differences between the control groups (P>0.05). ②Patients with elevated lactate dehydrogenase (LDH) (0.77 vs 1.38, z=−3.292, P=0.001) or International prognostic index (IPI)≥3(0.62 vs 1.29, z=−2.495, P=0.013) had lower expression level of GAS1. Patients with stage Ⅲ/Ⅳ disease (0.89 vs 1.18, z=−2.212, P=0.027) or IPI≥3 (0.48 vs 1.13, z=−2.008, P=0.045) had lower expression level of PRF1. IL-1RAP expression level was not associated with clinical features. ③ALK(+) ALCL patients in complete remission (CR) group had higher expression levels of GAS1 and PRF1 than patients in non-remission (NR) group (P values were 0.016 and 0.009). ④Kaplan-Meier survival analysis showed that patients with high expression levels of GAS1 and PRF1 had longer median overall survival and progression-free survival than patients with low expression levels of GAS1 and PRF1. CONCLUSION: GAS1, IL-1RAP and PRF1 could be molecular markers for ALK(+) ALCL patients. They have potential diagnostic value and can be used for differential diagnosis in some difficult cases. ALK(+) ALCL patients with high expression levels of GAS1 or PRF1 have better curative effects and prognoses.