摘要
目的从蛋白和基因水平研究弥漫性大B细胞淋巴瘤（DLBCL）的3q27染色体状态和不同亚型与预后的关系。方法应用免疫组织化学EnVision法对有随访资料的73例DLBCL进行CD3、CD10、CD20、bcl-6、MUM-1标记，根据Hans的分类方法分为生发中心B细胞型（GCB型）和非生发中心B细胞型（non-GCB型），其中54例应用荧光原位杂交（FISH）技术检测bcl-6基因所在的3q27染色体的断裂和扩增情况。结果73例DLBCL患者GCB型16例（21．9％），non-GCB型57例（78．1％）。54例DLBCL患者中3q27染色体断裂11例（20．4％），扩增14例（25．9％）。5年总体生存率GCB型（78％）高于non-GCB型（40％），差异有统计学意义（P=0．011）。bcl-6阳性表达较阴性者预后好（P=0．041）；3q27断裂阳性组病例总体生存率低于3q27断裂阴性组。结论DLBCL的GCB型比non-GCB型预后好。bcl-6蛋白表达有助于DLBCL的预后判断，3q27染色体断裂阳性病例总体生存率低于3q27断裂阴性组。目前仍有必要区分DLBCL的B细胞的起源。
Objective To study the immunophenotypic and genetic features of diffuse large B-cell lymphomas （DLBCLs） , and their relationship to prognosis. Methods Seventy-three cases of DLBCLs with follow-up data were studied by using immunohistoehemistry for CD3, CD10, CD20, bcl-6 and MUM-1. The DLBCLs were classified into germinal center B cell-like （GCB） and non-germinal center B cell-like （non- GCB） subtypes according to Hans＇ algorithm. Fluorescence in-situ hybridization （FISH） for bcl-6 gene expression （located on chromosome 3q27） was performed on paraffin-embedded tissues of 54 cases. Results In the 73 cases studied, 16 cases （21.9%） belonged to GCB subtype and 57 cases （78.1%） belonged to non-GCB subtype. Breakage of 3q27 was detected in 11 of the 54 cases （20.4%） and proliferation was detected in 14 eases （25.9%）. The five-year overall survival rate of GCB subtype was significantly higher than that of non-GCB subtype （78% versus 40% , P=0.011 ）. The bcl-6-positive cases had a better clinical outcome than that of the bcl-6-negative cases （ P = 0. 041 ）. Breakage of 3q27 predicted a worse overall survival. Conclusions The current study shows that the prognosis of GCB subtype of DLBCLs is better than that of non-GCB subtype. The expression of bcl-6 protein predicts a better clinical outcome, while the breakage of 3q27 predicts a worse overall survival.
出处
《中华病理学杂志》
CAS
CSCD
北大核心
2009年第4期231-236,共6页
Chinese Journal of Pathology
基金
山西省自然科学基金（2007011127）
山西省科技攻关项目（20080311062-2）
山西省留学人员重点科研资助项目（2008-10-5）
