摘要目的：探讨C-myc基因及蛋白与T淋巴母细胞淋巴瘤／白血病（ T-LBL／ALL）预后的相关性。方法应用免疫组织化学EnVision 法对山西省肿瘤医院病理科有详细随访资料的60例T-LBL／ALL石蜡标本进行CD1a、CD3、εCD3、CD7、CD10、CD34、CD43、CD45RO、CD99、末端脱氧核苷酸转移酶（ TDT）、CD20、CD23、髓过氧化物酶（ MPO）、Ki-67和C-myc免疫组织化学标记，用20例淋巴结反应性增生作为实验组中C-myc基因和蛋白表达异常的正常对照组。并用荧光原位杂交（ FISH）技术检测C-myc基因所在8q24染色体断裂和拷贝数异常的情况。结果60例T-LBL／ALL中，免疫组织化学结果显示：23例（38.3％） CD1a、45例（75.0％） CD3、27例（45.0％）εCD3、57例（95.0％） CD7、22例（36.7％）CD10、14例（23.3％） CD34、36例（60.0％） CD43、25例（41.7％） CD45RO、58例（96.7％）CD99、56例（93.3％）TDT阳性，CD20、CD23和MPO均为阴性。 Ki-67≤80％和＞80％分别为36例和24例。60例T-LBL／ALL中，C-myc蛋白的表达率为66.7％（40／60），20例淋巴结反应性增生全部阴性表达（0／20），二者C-myc蛋白阳性表达率差异有统计学意义（χ2＝26.67，P＜0.05）。C-myc蛋白表达与纵隔宽度、Ki-67呈正相关性（ P＜0.05）。 FISH 结果显示：60例T-LBL／ALL中， C-myc基因发生8q24染色体断裂6例（10.0％），拷贝数增加11例（18.3％）。20例淋巴结反应性增生均未发生C-myc基因断裂和拷贝数增加。 C-myc基因改变与C-myc蛋白表达无关（P＞0.05）。另外，在60例T-LBL／ALL中，C-myc蛋白及基因异常同时存在的病例有12例（20.0％）。单因素分析结果：C-myc蛋白阳性组预后比阴性组差（ P＜0.05）。 C-myc基因改变与预后差异无统计学意义（ P＞0.05）。 C-myc蛋白及基因异常同时存在与预后有关（ P＜0.05）。多因素COX分析结果显示，C-myc蛋白阳性组是独立的预后不良因素（ P＜0.05）。结论 T-LBL／ALL中，C-myc表达在T-LBL／ALL的发生发展中可能有重要作用，并且与预后差相关，提示为一种独立的预后因子。

abstractsObjective To study the C-myc gene and protein in T lymphoblastic lymphoma/leukemia ( T-LBL/ALL) and its relationship to prognosis.Methods 60 cases of T-LBL/ALL with follow-up data were studied by using immunohistochemical EnVision method for CD 1a, CD3,εCD3, CD7, CD10, CD34, CD43,CD45RO,CD99,TDT,CD20,CD23,MPO,Ki-67 and C-myc.20 cases of reactive lymph nodes were selected as normal control group of C-myc gene and protein.Fluorescence in-situ hybridization ( FISH) for C-myc gene ( located on chromosome8q24 ) was performed to detect its breakage and gain.Results&nbsp;Among the 60 cases of T-LBL/ALL, immunohistochemistry results showed:the percentages of tumor cells expression of CD1a, CD3, εCD3, CD7, CD10, CD34, CD43, CD45RO, CD99and TDT were 38.3%(23/60), 75.0%(45/60), 45.0%(27/60),95.0%(57/60),36.7%(22/60),23.3%(14/60), 60.0%(36/60),41.7%(25/60),96.7%(58/60)and 93.3%(56/60).Separately, while CD20 ,CD23 and MPO were all negative.A figure of Ki-67 expression≤80% was found in 36 cases and >80% was found in 24 cases.The positive rate of C-myc protein was 66.7%(40/60) in 60 cases of T-LBL/ALL,was 0%(0/20) in 20 cases of reactivated lymphoid tissue (χ2 =26.67,P<0.05).C-myc protein expression was positively correlated with the mediatinal width and Ki-67 index ( P <0.05 ).Fluorescence in-situ hybridization results showed that among the 60 cases of T-LBL/ALL, C-myc gene with breakage of 8q24 was detected in 6 cases ( 10.0%) , and gains in 11 cases ( 18.3%).20 cases of reactive lymph nodes were not occurred breakage and gains of C-myc gene .It is not significant between C-myc gene and protein expression (P>0.05).In addition, in 60 cases of T-LBL/ALL, 12(20.0%) cases of C-myc protein and genetic abnormalities coexist.Log-rank analysis results: The prognosis of C-myc protein positive group was worse than negative group ( P<0.05 ).The relationship of C-myc gene and prognosis was not significant ( P>0.05).C-myc protein and genetic abnormality coexist is related with worse prognosis ( P<0.05 ).COX analysis results show that the C-myc protein positive group may be a independent poor prognosis factors ( P<0.05).Conclusions C-myc may play an important role on the development of T-LBL/ALL.It may be a independent prognosis factors .