【摘要】 目的:探讨国内弥漫性大B细胞淋巴瘤(DLBCL)免疫表型分型及BCL-2和BCL-6基因异常的分布情况。方法:应用组织芯片和免疫组织化学法及FISH技术对219例DLBCL的免疫表型及BCL-2和BCL-6基因异常进行检测,根据Hans法进行分型;并收集国内7家相关研究报道,进行综合分析。结果:本组研究结果:219例DLBCL中,非GCB型(165例,75.3%)显著高于GCB型(54例,24.7%)(P<0.001)。BCL-2基因异常共49例(25.8%),其中t(14;18)5例(2.6%)均为GCB型;BCL-2基因扩增44例(23.2%),GCB型4例(8.5%),非GCB型40例(28.0%),有显著性差异(P=0.013)。BCL-6基因重排共42例(22.1%),GCB型7例(14.9%),非GCB型35例(24.5%),差异无统计学意义(P=0.189)。BCL-2基因扩增和BCL-6基因重排呈显著负相关(r=-0.180,P=0.013) 8组综合分析:1 259例中非GCB型(879例,69.8%)明显高于GCB型(380例,30.2%)(P<0.001);免疫表型中CD10和MUMl阳性率组间差异较小(P=0.047和P=0.048),而BCL-6及BCL-2阳性率组间存在明显差异(P<0.001)。结论:我国DLBCL患者在主要免疫表型和遗传学特征方面具有独特性,对此值得进行深入研究。更多还原

【Abstract】 Objective:To investigate the immunophenotypes,subtypes based on Hans algorithm,and alterations of Bcl-2 and Bcl-6 gene in diffuse large B-cell lymphoma(DLBCL) from Chinese patients.Methods:The expression of CD10,BCL-6,MUM1,BCL-2,Ki67 and other markers were detected by immunohistochemistry in tissue microarrays of 219 DLBCL cases.Hans algorithm was applied to classify DLBCL into GCB and non-GCB subtypes.Interphase fluorescence in situ hybridization(FISH ) was used to detect the incidence of Bcl-2 and Bcl-6 gene alterations.Other seven studies published in the last two years on DLBCL from China were collected and analyzed.Results: (1) This study:①of 219 DLBCL cases,non-GCB subtype(165 cases,75.3%) was significantly more common than GCB subtype(54 cases,24.7%)(P<0.001 ).②Bcl-2 gene alteration was detected in 49 cases(25.8%),including 5 cases with the t(14;18 )(2.6%) which all existed in GCB subtype,and 44 cases of Bcl-2 amplification(23.2%) which existed in GCB subtype in 4 cases(8.5%) and in non-GCB subtype in 40 cases(28.0%)(P = 0.013).③Bcl-6 gene rearrangement was detected in 42 cases(22.1%),which was in GCB in 7 cases(14.9%) and was in non-GCB in 35 cases(24.5%)(P = 0.189).④a significant negative correlation between Bcl-2 gene amplification and Bcl-6 gene rearrangement was seen(r = - 0.179 6,P = 0.016 8 ).Amongst 5 cases having the t(14;18 ) translocation, 2 cases accompanied by Bcl-6 gene rearrangement.Forty-nine cases with Bcl-2 gene alterations including translocation and amplification were all but one expressing BCL-2 protein,and there was no significant association between Bcl-6 gene rearrangement and BCL-6 protein expression(P = 0.726 ).⑤there was no significant difference between nodal and extranodal DLBCLs in immunophenotypes,subtypes based on Hans algorithm,and Bcl-2 and Bcl-6 gene alterations(P = 0.462,P = 0.426 and P = 0.167 ).(2) Comprehensive analysis of eight studies: of the total 1,259 cases,non-GCB subtype(879 cases,69.8%) was significantly more common than GCB subtype(380 cases,30.2%) (P<0.001 ).Conclusion:There are some distinctive features on immunophenotypes and cytogenetic alterations in DLBCL of Chinese patients,which need elucidation by more studies.更多还原