Expression And Clinical Significance Of SMAC And LIVIN In Non-Hodgkin's Lymphoma

Background:Non-Hodgkin's lymphoma(NHL) is a serious of malignant tumors. They have multiplicity clinical manifestation,heterogeneous biological behavior,and difference in curative effect and prognosis.T-NHL and B-NHL are two categories in NHL.They have significant difference in Chemotherapy effect and prognosis.But the reason is not clear.The occurrence and development of NHL covers many stages and involves the change of various cell genetic materials,among which the alteration of apoptosis-related genes and their expression play an important role.Additionally,the mechanism of anticancer is implemented through inducing cell apoptosis,so if apoptosis-related genes alter in malignant lymphoma,the effects of anti-tumor drugs will change inevitably.Thus,investigating apoptosis-related genes' expression in NHL may offer us important value in understanding different bionomics between T-NHL and B-NHL,selecting indicators related prognosis and predicting theruputic effect.Livin is the most powerful apoptosis inhibitory factor in lAPs family.Livin regulated by the cell signal transduction pathway of PI3K/Akt has a direct effect on Caspase-3 and Caspase-7.Smac,discharged to cytoplasm by mitochondria,is an important apoptosis regulatory factor.It may combine with all the IAPs that have been discovered and cause them to lose their activity to inhibit caspase.At the same time, Livin,as E3 ubiquitin ligases,may dissolve Smac.Both are mutual antagonism and mutual adjustment.In this study on NHL,selecting Livin and Smac has important significance in identificating prognosis and predicting chemotheraputic effect. Objective:To detect the expression of Livin and Smac proteins in T-NHL and B-NHL,investigate the relationship between the two genes' expressions and NHL's clinical features,chemotheraputic effect,and prognosis.To understand the different biological characteristics between T-NHL and B-NHL,then provide valuable molecular indicators for NHL's prognosis.Method:We selected 82 cases of non-Hodgkin's lymphoma samples diagnosed by first affiliated hospital to Anhui Medical college of pathology department,including 40 cases of B-NHL,42 cases of T-NHL.Using the immunohistochemistry method to examine Livin and the Smac protein expression in paraffin-embedded sections;Then we analyzed correlation their expression with clinical features,chemotheraputic effect, and the survival study in 26 cases of B-NHL and 25 cases of T-NHL with complete follow-up information.Results:1.Both in T-NHL and B-NHL,Livin and Smac proteins were expressed,but we didn't present the significant different rates.2.The expression of Livin and Smac proteins had the relevance in NHL types. They showed negative correlation in T-NHL,while positive correlation in B-NHL.3.The meaning of Livin protein's expression is different in T-NHL and B-NHL, it had relation with the existence of B symptoms,the international prognostic index for high-risk patients and Short survival time,and was a poor prognosis indicator. While in B-NHL,it was a good prognosis indicator because of the correlation of no B symptoms,better recent effects of chemotherapy and longer survival time.4.In T-NHL and B-NHL,the expression of Smac protein had relevance with no B symptoms,Ⅰ～Ⅱstages in Ann Arbor stage and the international prognostic index for low-risk patients;But had no relevance with the age,gender,recent effects of chemotherapy and survival time. Conclusion:1.Livin and Smac proteins were expressed both in T-NHL and B-NHL.2.The expression of Livin and Smac proteins presented negative correlation in T-NHL,while positive correlation in B-NHL.3.The meaning of Livin protein's expression is different in T-NHL and B-NHL. It related with poor prognosis in T-NHL,but better prognosis in B-NHL.While the expression of Smac protein was related with better prognosis in T-NHL and B-NHL.4.In T-NHL,the expression of Livin protein had no corelation with recent effects of chemotherapy,but had relationship with survival time;While in B-NHL,it had relationship with recent effects of chemotherapy and survival time;Whether in T-NHL or B-NHL,the expression of Smac protein had nothing to do with recent chemotherapy effect and survival time.