Application Of Next Generation Sequencing Technique In Extranodal NK/T Cell Lymphoma And Analysis Of Related Prognostic Factors

Objective : Extranodal NK / T-cell lymphoma is the most common subtype of peripheral T-cell lymphoma and has unique epidemiological characteristics.It is more common in East Asia and South America.It has poor prognosis.The pathogenesis is not clear.In order to further understand the nature of the disease and explore the potential target of its treatment strategy,we selected nine genes with high correlation with the disease by referring to the literatures in recent 10 years to analyze the relationship between the mutation of the target gene,the prognosis and clinical characteristics.This study will provide a theoretical basis for the pathogenesis,clinical diagnosis and targeted therapy of NK / T cell lymphoma.Method:1 We screened 29 patients with NK / T cell lymphoma who were newly diagnosed at the Fourth Hospital of Hebei Medical University from August2010 to November 2016,and the clinical data were complete.The mutation of nine target genes in the specimen was detected by the next-generation sequencing.2 The relationships between the prognosis of the disease,the clinical features and the mutation of the target genes were analyzed by SPSS21.0statistical software.Results1 Mutations of target gene were ARID1 A 34.48%(10 cases),KMT2D31.03%(9 cases),TP53,MGA,STAT3 were 24.13%(7 cases),EP300 and ASXL3 were 17.24%(5 cases),DDX3 X and STAT5 B were 6.89%(2 cases).2 Kaplan-Meier survival analysis showed that KMT2 D gene,Ann Arbor stage,age,treatment,IPI score,PIT score,KPI score,PINK score,Ki67 level,peripheral blood lymphocyte count,serum LDH level,pre-treatment albumin level,elevated transaminase had a significant effect on the overall survival of patients with NK / T cell lymphoma(P <0.05).STAT3 gene had a significant effect on progression-free survival in patients with ENKTL(P<0.05).Compared with the four prognostic scores,the PINK prognosis was found to be more suitable for ENKTL.3 KMT2 D gene mutation was found to be related to stage,the levels of CRP,albumin,lymphocyte count and Ki67 in patients with extranodal NK / T cell lymphoma.(P <0.05).4 The multivariate analysis of COX proportional risk regression showed that the KMT2 D gene was statistically significant(P <0.05).Conclusions:1 Mutation of KMT2 D gene in extranodal NK / T cell lymphoma is high.There was a correlation between KMT2 D gene mutation and stage,CRP,albumin,peripheral blood lymphocyte count and Ki67 level in patients with extranodal NK / T cell lymphoma.2 Patients with KMT2 D mutant had poor prognosis.The KMT2 D mutant is an independent prognostic factor.KMT2 D gene may play an important role in the development of extranodal NK / T cell lymphoma as a tumor suppressor gene.3 STAT3 gene mutations may play an important role in the proliferation and invasion of tumor cells in ENKTL.4 TP53 and ARID1 A gene mutations may be prognostic factors for extranodal NK / T cell lymphoma.