摘要
目的:分析90例弥漫性大B细胞淋巴瘤(diffuse large B-cell lymphoma,DLBCL)的临床病理学特征及其临床意义。方法:收集90例DLBCL石蜡包埋组织标本及预后资料,采用免疫组织化学技术及间期荧光原位杂交(Fluorescence in situ Hybridization,FISH)技术研究其免疫表型和分子遗传学特征。结果:本组病例中,70例原发于淋巴结外,20例原发于淋巴结。根据Hans模型,42.2%(38/90)的DLBCL起源于生发中心B细胞(GC),57.8%(52/90)起源于非生发中心B细胞(Non-GC)。IGH、bcl-6、bcl-2及c-myc基因易位的阳性率分别为33.3%(30/90)、22.2%(20/90)、4.4%(4/90)和3.3%(3/90);bcl-2、bcl-6、c-myc及IGH基因多拷贝的阳性率分别为51.1%(46/90),40%(36/90)、30%(27/90)和14.4%(13/90)。20例bcl-6基因易位的DLBCL中,14例为Non-GC起源,6例为GC起源;4例bcl-2基因易位的病例中,3例为GC起源,1例为Non-GC起源;3例c-myc基因易位的病例中,2例为GC起源,1例为Non-GC起源。结外DLBCL的IGH基因易位的阳性率高于结内者(P<0.05);结内DLBCL的c-myc基因多拷贝的阳性率高于结外者(P<0.05)。本组29例有随访结果的病例显示,IGH、bcl-6、bcl-2及c-myc基因易位及多拷贝与预后无明显相关(P>0.05)。结论:本组DLBCL总的分子遗传学异常率(包括因易位及拷贝数的异常)为82.2%,其中以bcl2多拷贝(51.1%)最为多见。不存在IGH、bcl-6、bcl-2及c-myc基因异常,不能除外DLBCL的诊断。少部分DLBCL中存在Burrkitt淋巴瘤特征性的c-myc基因易位。IGH、bcl-2、bcl-6及c-myc基因易位及拷贝数的异常在DLBCL中不具有的预后判定意义。
Objective： To study the pathological and molecular genetic features for diffuse large B-cell lymphoma（DLBCL） and to explore their implication for prognosis. Methods： Ninety DLBCL tumor specimen with paraffin-embedded tissues were collected. The immnuphenotype was analyzed by immunohistochemical method and the molecular genetic changes were investigated by interphase fluorescence in situ hybridization（FISH）. Results： Seventy cases were originated from extranodal sites and 20 cases were originated from lymph nodes. According to Hans algorism, 42.2%（38/90） cases were of GC type and 57.8%（52/90）were of non-GC type. The frequencies of IGH, BCL6, BCL2 and c-myc rearrangements were 33.3%（30/90）, 22.2%（20/90）, 4.4%（4/90） and 3.3%（3/90）, respectively. The frequencies of BCL2, BCL6, MYC and IGH extra copy were 51.1%（46/90）, 40%（36/90）, 30%（27/90） and 14.4%（13/90）, respectively.Fourteen cases were of the Non-GC type and six cases were of GC type in the 20 cases with Bcl6 rearrangements. Three cases were of GC type and one case was of non-GC type in the four cases with BCL2 rearrangements. Two cases were of GC type and one case was of non-GC type in the three cases with c-myc rearrangements. The frequencies of IGH rearrangements in extranodal group was significantly higher than it in the nodal group（P0.05）. The frequencies of c-myc extra copy in the nodal group was significantly higher than it in the extronodal group. No correlation between the IGH, BCL6, BCL2 and c-myc rearrangements and extra copy with prognosis were observed in the 29 patients with follow-up data. Conclusion： IGH, BCL6, BCL2 and c-myc rearrangements and extra copy with prognosis were detected in our series of DLBCL cases and no significant relationship of these changes with prognosis was observed.
出处
《现代生物医学进展》
CAS
2013年第30期5841-5846,共6页
Progress in Modern Biomedicine
基金
北京市自然科学基金项目(7132062)
关键词
弥漫性大B细胞淋巴瘤
易位
多拷贝
Diffuse large B-cell lymphoma
Translocation
Extra copy
