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南京医科大学学报(自然科学版)                                  第45卷第5期
               ·644 ·                     Journal of Nanjing Medical University(Natural Sciences)   2025年5月


             ·临床研究·

              CYB5R2在弥漫大B细胞淋巴瘤中的表达及其临床意义



              孙书凝 ,龚予希 ,杨野梵 ,甘芠源 ,陈                刚 ,肖菁娇 ,张诗婷 ,张智弘           1*
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               南京医科大学第一附属医院病理科,肿瘤科,江苏                  南京 210029
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             [摘    要] 目的:探讨细胞色素B5还原酶2(NADH⁃cytochrome B5 reductase 2,CYB5R2)在弥漫大 B 细胞淋巴瘤(diffuse large B⁃
              cell lymphoma,DLBCL)中的表达特征及其对临床预后的指示价值,为DLBCL分子分型及个体化治疗提供新依据。方法:本研
              究采用生物信息学分析与临床验证相结合的策略。首先于 TCGA 数据库获取 DLBCL 相关的差异表达基因数据集,应用
              DAVID 6.8平台进行GO功能富集分析筛选关键基因CYB5R2。基于TCGA和GTEx数据库整合分析CYB5R2在DLBCL组织与
              正常淋巴组织中的表达差异。基于免疫组化判读分析CYB5R2蛋白在DLBCL和小B细胞淋巴瘤中的表达差异。进一步通过
              回顾性队列研究,纳入南京医科大学第一附属医院 2015 年 1 月—2019 年 12 月经病理确诊且随访资料完整的 59 例 DLBCL 患
              者,采用组织化学染色检测肿瘤组织中 CYB5R2 蛋白表达水平,结合临床病理特征[包括 Ann Arbor 分期、细胞起源(cell of
              origin,COO)分型、乳酸脱氢酶(lactate dehydrogenase,LDH)水平、CD10表达状态等]及治疗反应[完全缓解(complete response,
              CR)率]进行相关性分析。采用 Kaplan⁃Meier 法绘制生存曲线,Log⁃rank 检验比较生存差异。结果:生物信息学分析显示,
              CYB5R2在DLBCL组织中显著高表达(P < 0.05)。临床队列验证发现CYB5R2在LDH升高病例中的阳性表达高于LDH正常病
              例(χ =4.832,P=0.028);在Non⁃GCB 亚型病例的阳性表达高于GCB 亚型病例(χ =4.468,P=0.035);在CD10阳性病例中的阳性
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              表达高于 CD10 阴性病例(χ =4.468,P=0.035)。生存分析表明,CYB5R2 高表达患者的 5 年总生存期(overall survival,OS)显著
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              低于 CYB5R2 零或低表达患者(χ =4.799,P=0.028);高表达患者的 CR 率显著低于 CYB5R2 零或低表达患者(χ =4.015,P=
              0.045)。结论:CYB5R2在DLBCL中呈现特征性高表达模式,其过表达与Non⁃GCB亚型、LDH升高等不良预后因素显著相关,
              提示其可为完善DLBCL的分子分型体系及开发靶向代谢治疗策略提供新的理论依据。
             [关键词] 弥漫大B细胞淋巴瘤;CYB5R2;免疫组织化学;预后
              [中图分类号] R733.1                   [文献标志码] A                      [文章编号] 1007⁃4368(2025)05⁃644⁃08
              doi: 10.7655/NYDXBNSN241319


              Expression and clinical significance of CYB5R2 in diffuse large B⁃cell lymphoma

              SUN Shuning ,GONG Yuxi ,YANG Yefan ,GAN Wenyuan ,CHEN Gang ,XIAO Jingjiao ,ZHANG Shiting ,
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              ZHANG Zhihong
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              1 Department of Pathology,Department of Oncology,the First Affiliated Hospital of Nanjing Medical University,
              Nanjing 210029,China
             [Abstract] Objective: To investigate the expression characteristics of cytochrome B5 reductase 2(NADH⁃cytochrome B5 reductase
              2,CYB5R2)in diffuse large B⁃cell lymphoma(DLBCL)and its prognostic value,providing new insights for molecular classification
              and individualized treatment of DLBCL. Methods:This study employed a combined strategy of bioinformatics analysis and clinical
              validation. First,differentially expressed gene datasets of DLBCL were obtained from the TCGA database,and the DAVID 6.8 platform
              was used for GO functional enrichment analysis to identify key genes,such as CYB5R2. The differences in expression of CYB5R2
              between DLBCL tissues and normal lymphatic tissues were analyzed based on integrated data from the TCGA and GTEx databases.
              Additionally,a retrospective cohort study was conducted,including 59 DLBCL patients diagnosed pathologically with complete follow⁃
              up data from Jan. 2015 to Dec. 2019 in the First Affiliated Hospital of Nanjing Medical University. Immunohistochemical staining was
              used to detect CYB5R2 protein expression levels in tumor tissues,and their correlations with clinicopathological features[including
              Ann Arbor staging,cell of origin(COO)classification,lactate dehydrogenase(LDH)levels,CD10 expression status,etc.]and
              treatment response[complete response(CR)rate]were analyzed. Kaplan⁃Meier survival curves were plotted,and survival differences

             [基金项目] 江苏省医学重点学科和医学重点实验室建设(JSDW202248)
              通信作者(Corresponding author),E⁃mail: zhangzh@njmu.edu.cn(ORCID:0000⁃0002⁃5779⁃9365)
              ∗
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