摘要
目的探讨CD5^(+)的原发性弥漫大B细胞淋巴瘤(diffuse large B cell lymphoma,DLBCL)的临床病理学特征及其分子突变特征谱。方法采用免疫组化染色和二代测序技术(NGS)检测,比较原发性CD5^(+)DLBCL和CD5^(-)DLBCL的病理学特征、免疫表型和基因变异谱的差异,分析其与患者临床病理特征及预后的关系。结果311例DLBCL样本中CD5^(+)DLBCL患者46例(14.7%)。CD5^(+)DLBCL与CD5^(-)DLBCL、CD5^(+)DLBCL伴MYD88 L265P变异和不伴MYD88 L265P变异相比,患者性别、临床分期和国际预后指数等差异无统计学意义(P>0.05)。免疫表型:CD5^(+)DLBCL组BCL2过表达率(69.5%vs 49.4%,P=0.003)、BCL2和C-MYC双表达率(26%vs 14%,P=0.04)均高于CD5^(-)DLBCL组;CD5^(+)伴MYD88 L265P变异组C-MYC(53%vs 20%)、BCL6(93.3%vs 61.3%)、Ki67(93.3%vs 64.5%)等标记及双表达(46.7%vs 20.8%)均高于CD5^(+)不伴MYD88 L265P变异组患者(P<0.05)。生存分析表明,CD5^(+)DLBCL组患者疾病无进展生存时间比CD5^(-)DLBCL组患者更差(P=0.09)。此外,CD5^(+)不伴MYD88 L265P变异患者无进展生存时间明显优于CD5^(+)伴MYD88 L265P变异患者(P=0.04)。NGS检测发现,CD5^(+)DLBCL和CD5^(-)DLBCL两组患者在伴随突变基因的分布有差异。结论CD5^(+)标记以及CD5^(+)伴MYD88 L265P变异,可能是DLBCL患者预后不佳的潜在标志物。
Purpose To explore the clinicopathological features and molecular characteristics of primary CD5^(+)diffuse large B cell lymphoma(DLBCL).Methods Immunohistochemistry and next-generation sequencing(NGS)were used to compare the pathological features,immunophenotypes,and molecular characteristics between primary CD5^(+)DLBCL and CD5^(-)DLBCL,and to analyze their relationship with prognosis and clinical characteristics of patients.Results Among 311 DLBCL patients,there were 46 cases(14.7%)of CD5^(+)DLBCL.There were no statistically significant differences in patient gender,clinical staging,international prognostic index between CD5^(+)DLBCL and CD5^(-)DLBCL,and between CD5^(+)DLBCL with and without MYD88 L265P mutation(P>0.05).Immunophenotypically,the overexpression of BCL2(69.5%vs 49.4%,P=0.003)and the co-expression of BCL2 and C-MYC(26%vs 14%,P=0.04)were higher in the CD5^(+)DLBCL group than those in the CD5^(-)DLBCL group;the expression of C-MYC(53%vs 20%),BCL6(93.3%vs 61.3%),Ki67(93.3%vs 64.5%),and co-expression(46.7%vs 20.8%)were higher in the CD5^(+)with MYD88 L265P mutation group than those in the CD5^(+)without MYD88 L265P mutation group(P<0.05).Survival analysis showed that the disease progression-free survival time of patients in the CD5^(+)DLBCL group tended to be shorter than that of patients in the CD5^(-)DLBCL group(P=0.09).Furthermore,the disease progression-free survival time of patients in the CD5^(+)without MYD88 L265P mutation group was significantly longer than that of patients in the CD5^(+)with MYD88 L265P mutation group(P=0.04).NGS detection found differences in the distribution of accompanying mutated genes between CD5^(+)DLBCL and CD5^(-)DLBCL groups.Conclusion CD5 expression and CD5^(+)with MYD88 L265P mutation may be potential indicators of poor prognosis in DLBCL patients.
作者
谢嘉玲
施晴
鲍其远
董磊
XIE Jialing;SHI Qing;BAO Qiyuan;DONG Lei(Department of Pathology,Ruijin Hospital,School of Medicine,Shanghai Jiao Tong University,Shanghai 200020,China;Department of Hematology,Ruijin Hospital,School of Medicine,Shanghai Jiao Tong University,Shanghai 200020,China;Department of Orthopedics,Ruijin Hospital,School of Medicine,Shanghai Jiao Tong University,Shanghai 200020,China)
出处
《临床与实验病理学杂志》
CAS
北大核心
2024年第1期29-34,共6页
Chinese Journal of Clinical and Experimental Pathology
