【摘要】 目的探讨弥漫性大 B 细胞淋巴瘤(DLBCL)的临床生物学特征和预后并比较结内与结外的差异。方法分析142例 DLBCL 的临床病理资料,结内90例,结外52例(胃肠30例,其他22例),并随访2～108个月,制备组织芯片,并经免疫组织化学 EnVision 法染色,观察 CD10、bcl-6、MUM1蛋白的表达并进一步区分其生发中心 B 细胞(GCB 细胞)和非生发中心 B 细胞的分化特征。结果胃肠道 DLBCL 常为Ⅰ～Ⅱ期,国际预后指标评分低,预后也好于结内及其他结外 DLBCL。单个抗原的表达率,CD10为19%(27例),bcl-6为51%(72例),MUM1为58%(82例)。36%(51例)的 DLBCL 显示 GCB 细胞分化特征,64%(91例)的 DLBCL 显示非 GCB 细胞分化特征。结外 DLBCL的 bcl-6的表达(63%)高于结内 DLBCL(43%)。在不同的结外部位,甲状腺等部位多见为 GCB 细胞分化的 DLBCL;睾丸等部位多见为非 GCB 细胞分化的 DLBCL。结论 DLBCL 显示生发中心 B 细胞和非生发中心 B 细胞分化特征,结内外以及结外不同部位的 DLBCL 有着不同的生物学特征和预后。更多还原

【Abstract】 Objective To study the clinicopathologic features and outcome of patients with diffuse large B-cell lymphoma(DLBCL),and to compare the differences between DLBCL of nodal and extranodal origins.Methods One hundred and forty-two cases of de novo DLBCL collected during a 10-year period were reviewed.The clinicopathologic features and follow-up(2-108 months)data were analyzed.Tissue microarray blocks were performed and immunohistochemical studies using antibodies against CD10,bcl-6 and MUM1 were carried out.The cases were then further categorized into germinal center B cell-like(GCB) and non-GCB subtypes.Results Primary gastrointestinal DLBCL often presented as early-stage disease (stage Ⅰ or Ⅱ)and was associated with low international prognostic index.They showed better prognosis than DLBCL of nodal and other extranodal origins.The positivity rates of CD10,bcl-6 and MUM1 were 19%,51% and 58%,respectively.36% of the cases belonged to GCB,while the remaining 64% were non-GCB.In general,DLBCL of extranodal origin showed more frequent bcl-6 expression than nodal DLBCL.As for extranodal DLBCL,GCB immunophenotype was often seen in thyroid and breast tumors, while testicular DLBCL usually carried a non-GCB immunophenotype.Conclusions DLBCL of various origins show a diversified GCB and non-GCB differentiation.Nodal and extranodal DLBCL,as well as extranodal DLBCL from different primary sites,carry different biologic characteristics and prognostic implications.更多还原