原发性骨非霍奇金淋巴瘤临床病理预后和病因学分析  

Clinicopathologic features, prognosis and etiology of primary non-Hodgkin lymphoma of bone

作　　者：周志毅[1] 石群立[1] 周晓军[1] 兰建云[1] 王建东[1] 黄文斌[1] 陈洁宇[1] 马恒辉[1] 周航波[1] 

机构地区：[1]南京大学医学院临床学院 南京军区南京总医院病理科,210002

出　　处：《中华病理学杂志》2007年第2期90-93,共4页Chinese Journal of Pathology

基　　金：江苏省"六大人才高峰"基金(2005A2)

摘　　要：目的探讨原发性骨非霍奇金淋巴瘤(PNHLB)的临床病理特征、预后指标及病因学。方法复习17例 PNHLB 患者的临床资料,同时进行免疫组织化学 EnVision 法检测免疫标志物、原位杂交检测 EBER 及 PCR 检测 bcl-2/JH 基因重排,并对血清 LDH、治疗、国际预后指数(IPI)、免疫标志物与预后的关系进行分析。结果 17例 PNHLB 以弥漫性大 B 细胞淋巴瘤为主(94.1%),患者的5年生存率为68.8%,IPI 高危类、bcl-2过表达对预后不利(2者的 P 值分别为0.031和0.028),治疗方式和 CD10、MUM-1、bcl-6的表达对预后的判断差异无统计学意义(P>0.05)。8例人类β-珠蛋白基因扩增阳性的骨 DLBCL 患者中1例 Bcl-2/JH 基因重排扩增阳性。EBER 原位杂交仅1例阳性。结论 PNHLB 预后较好,IPI 及免疫组织化学检测 bcl-2过表达是判断预后的指标。EB 病毒与病因无相关性。Objective To study the clinicopathologic features, prognostic indicators and possible etiology of primary non-Hodgkin lymphoma of bone （PNHLB）. Methods The clinicopathologic features of 17 cases of PNHLB were reviewed. In-situ hybridization for Epstein-Barr virus early RNA （EBER） and polymerase chain reaction for bcl-2/JH gene rearrangement were performed using paraffin-embedded materials. The correlation between serum lactic dehydrogenase level, treatment options, international prognostic indicator （IPI） and immunophenotype with clinical outcome were analyzed. Results The majority of the 17 cases studied was diffuse large B-cell lymphoma （94. 1% ）. The 5-year survival rate was 68.8%. Unfavorable prognostic factors included high-risk IPI （P =0. 031 ） and bcl-2 overexpression （ P = 0. 028 ）. Treatment options and expression of CD10, MUM-1 or bcl-6 did not correlate with clinical outcome （ P 〉 0. 05 ）. Only 1 patient was positive for EBER, as demonstrated by in-situ hybridization. Conclusions The clinical outcome of PNHLB is relatively favorable. IPI and bcl-2 expression may serve as useful prognostic indicators. EBV is likely not related to pathogenesis of this type of lymphoma.

关 键 词：骨肿瘤 淋巴瘤 非霍奇金 预后 

分 类 号：R738.1[医药卫生—肿瘤]