广西医学

目的探讨弥漫大B细胞淋巴瘤（DLBCL）患者甲基化转移酶3（METTL3）、Wilms肿瘤抑制因子（WTAP）的表达及临床意义。方法选取84例初诊DLBCL患者为DLBCL组，50例反应性淋巴结增生（RLH）患者为RLH组。比较两组患者METTL3、WTAP表达情况，比较不同临床特征DLBCL患者METTL3、WTAP的表达情况，分析DLBCL患者METTL3与WTAP表达的相关性，比较METTL3、WTAP不同表达情况DLBCL患者短期的化疗疗效，绘制Kaplan⁃Meier曲线分析METTL3、WTAP表达情况与DLBCL患者预后的关系。采用COX比例风险模型分析影响DLBCL患者预后的因素。结果 DLBCL组METTL3、WTAP阳性率高于RLH组（P<0.05）。DLBCL患者METTL3表达情况与WTAP表达情况呈正相关（P<0.05）。Ann Arbor临床分期为Ⅲ~Ⅳ期、Hans分型为非GCB型的DLBCL患者METTL3、WTAP阳性率高于Ann Arbor临床分期为Ⅰ~Ⅱ期、Hans分型为GCB型的患者（P<0.05）。METTL3、WTAP阳性患者客观缓解率、3年生存率分别低于METTL3、WTAP阴性患者（P<0.05）。Ann Arbor临床分期为Ⅲ~Ⅳ期、METTL3阳性、WTAP阳性是影响DLBCL患者预后的危险因素（P<0.05）。结论 DLBCL患者METTL3、WTAP表达升高，其表达情况与DLBCL患者的Ann Arbor临床分期和Hans分型有关，且METTL3、WTAP高表达者3年生存率较低，两者均是DLBCL预后的影响因素。

Objective To investigate the expression and clinical significance of methyltransferase like 3 (METTL3) and Wilms' tumor 1⁃associating protein (WTAP) in patients with diffuse large B⁃cell lymphoma (DLBCL). Methods A total of 84 newly diagnosed DLBCL patients were selected as the DLBCL group, and 50 patients with reactive lymph node hyperplasia (RLH) as the RLH group. Expressions of METTL3 and WTAP were compared between patients of the two groups, and between DLBCL patients with different clinical characteristics. The correlation between METTL3 expression and WTAP expression was analyzed in DLBCL patients. The short⁃term chemotherapy efficacy was compared between DLBCL patients with different expressions of METTL3 and WTAP. The Kaplan⁃Meier curve was drawn to analyze the relation of METTL3 and WTAP expressions with prognosis of DLBCL patients. The COX proportional risk model was adopted to analyze the factors for affecting prognosis of DLBCL patients. Results The positive rates of METTL3 and WTAP were higher in the DLBCL group than in the RLH group (P<0.05). METTL3 expression positively correlated with WTAP expression in DLBCL patients (P<0.05). DLBCL patients with Ann Arbor clinical staging in Ⅲ-Ⅳ, Hans classification in non⁃GCB type obtained higher positive rates of METTL3 and WTAP as compared with DLBCL patients with Ann Arbor clinical staging in Ⅰ-Ⅱ, Hans classification in GCB type (P<0.05). The objective remission rate and 3⁃year survival rate of patients with METTL3 and WTAP positive were lower as compared with patients with METTL3 and WTAP negative, respectively (P<0.05). Ann Arbor clinical staging in Ⅲ-Ⅳ, METTL3 positive, WTAP positive were the risk factors for affecting the prognosis of DLBCL patients (P<0.05). Conclusion Expressions of METTL3 and WTAP are elevated in DLBCL patients, their expressions are related to Ann Arbor clinical staging and Hans classification of DLBCL patients. Patients with high METTL3 and WTAP expressions obtain a relatively low 3⁃year survival rate, and both two as above are the influencing factors for DLBCL prognosis.