B细胞性非霍奇金淋巴瘤中BCL-6、CD10和BCL-2的蛋白表达及其临床病理意义  

BCL-6,CD10 and BCL-2 protein expression in B-cell Non-Hodgkin's lymphoma and its clinicopathologic significance

作　　者：闵大六[1] 周晓燕[1] 陆洪芬[1] 许越香 范月珍 郑爱华 施达仁 

机构地区：[1]复旦大学附属肿瘤医院分子病理室复旦大学上海医学院肿瘤学系,上海200032

出　　处：《中国癌症杂志》2006年第3期169-173,共5页China Oncology

基　　金：国家自然科学基金资助项目(39900065)

摘　　要：背景与目的:BCL-6、CD10均为淋巴结生发中心B淋巴细胞(GC-B细胞)的标志,它们在结内外弥漫性大B细胞淋巴瘤(DLBCL)及其它类型淋巴瘤中的表达特征及意义值得研究。本研究分析了B细胞性非霍奇金淋巴瘤(B-NHL)中BCL-6、CD10和BCL-2的蛋白表达及其临床病理意义。方法:免疫组化EnV ision两步法分析135例B-NHL常见类型[包括DLBCL 22例,滤泡性淋巴瘤(FL)18例,B小淋巴细胞性淋巴瘤(B-SLL)18例,套细胞淋巴瘤(MCL)15例,淋巴浆细胞性淋巴瘤(LPL)7例,Burk itt’s淋巴瘤(BL)5例,B淋巴母细胞性淋巴瘤(LBL)3例;结外DLBCL 29例,胃粘膜相关淋巴样组织结外边缘区B细胞淋巴瘤(MALT-L)18例]和对照组5例T-NHL、5例结节型淋巴细胞为主型霍奇金淋巴瘤(NLPHL)以及10例淋巴结反应性增生(RLH)石蜡包埋组织中BCL-6、CD10以及BCL-2蛋白的表达。结果:①BCL-6和CD10阳性表达均只见于RLH(100%和100%)、结内DLBCL(72.7%和40.9%)、结外DLBCL(75.9%和41.4%)、FL(88.9%和72.2%)以及BL(100%和100%),其余B-NHL如B-SLL、MCL、MALT-L、LPL、LBL以及T-NHL和NLPHL中均未见BCL-6和CD10蛋白的表达。BCL-2蛋白表达可见于结内、结外DLBCL、FL、B-SLL、MCL、MALT-L以及LBL,阳性率分别为:36.4%、27.6%、83.3%、88.9%、86.7%、72.7%和33.3%;而LPL、BL、T-NHL以及NLPHL未见BCL-2蛋白表达;②DLBCL中BCL-6的表达形式可以分为四种类型:GC/FL型、中间型、散在型和阴性型;③40.9%的结内DLBCL、41.4%的结外DLBCL、72.2%的FL以及100%的BL为BCL-6+/CD10+表达,其中BCL-6蛋白表达均为GC/FL型;④在临床特征上,BCL-6+/CD10+的结内DLBCL与非BCL-6+/CD10+的结内DLBCL相比,前者的临床分期低于后者(P<0.05)。结论:BCL-6、CD10和BCL-2蛋白的联合检测,可以用于部分B-NHL的诊断和鉴别诊断;BCL-6+/CD10+的结内淋巴瘤可能具有更好的临床预后。Background and Purpose： Both Bcl-6 and CD10 are markers of germinal center（GC） B cells in the lymph node. Their experssion in nodal diffuse large B cell lympoma（ DLBCL）, extranodal DLBCL and other types of lymphoma and the sigifcance is worthy to he investigated. This paper will investigate the protein expression of BCL-6, CD10, BCL- 2 gene in B-cell Non-Hodgkin＇ s [ymphomas（B-NHL） in Chinese populations and its clinic-pathological significance, Methods： Immunohistochemical analyses of BCL-6, CD10 and BCL-2 protein expression were performed on 135 cases of B- NHL including the common types occurring in Chinese populations and 5 eases of T-NHL, 5 cases of nodular lymphocyte predominance Hodgkin＇ s lymphoma （NLPHL） and 10 eases of Reactive lymphoid hyperplasia （RLH） with paraffin-embedded tissues. Results： ① BCL-6 and CD10 protein were expressed almost exclusively in RLH, nodal DLBCL, extranodal DLBCL, follicular lymphoma （FL） and Burkitt＇ s lymphoma （BL）, the rates of positivity were 100% and 100%, 72.7% and 40.9%, 75.9% and 41.4%, 88.9% and 72.2% as well as 100% and 100%, respectively. BCL-6 and CD10 protein were not expressed in other B-NHL such as small lymphocytic lymphoma （ B-SLL）, mantle cell lymphoma （MCL）, extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue （MALT-L）, Lymphoplasmacytic lymphoma （LPL） and lymphoblastic lymphoma （LBL） as well as T-NHL and NLPHL. BCL-2 protein were expressed in nodal DLBCL,extranodal DLBCL,FL, B-SLL, MCL, MALT-L and LBL, the rates of positivity were 36.4%, 27.6%, 83.3%,88.9% ,86.7% ,72.7% and 33.3%, respectively. BCL-2 protein were not expressed in LPL, BL, T-NHL and NLPHL. ② BCL-6 protein expression in DLBCL could be classified into four patterns. GC/FL pattern, intermediate pattern, sporadic pattern and rare or absent pattern. ③ The coexpression of BCL-6 and CD10 was observed in 40.9% nodal DLBCL, 41. 4% extranodal DLBCL, 72.2% FL and 100% BL. Among them the BCL-6 protein expressions

关 键 词：B细胞性非霍奇金淋巴瘤 BCL-6 CD10 蛋白表达 

分 类 号：R733[医药卫生—肿瘤]