间变性大细胞淋巴瘤中ALK与clusterin的表达及其临床病理意义  

Expression of ALK and clusterin in anaplastic large cell lymphoma and their clinicopathological significance

作　　者：黄文涛[1] 陆永明[1] 周晓燕[1] 李小妹[1] 姚晓红[2] 李百周[1] 张太明[1] 金爱萍[1] 

机构地区：[1]复旦大学附属肿瘤医院病理科 [2]上海交通大学医学院附属新华医院病理科,上海200092

出　　处：《中国癌症杂志》2007年第6期439-443,共5页China Oncology

基　　金：上海市科技发展基金(No:054119638)

摘　　要：背景与目的：间变性淋巴瘤激酶（ALK）是系统性间变性大细胞淋巴瘤（ALCL）较为特异的标志,近来研究发现一种新的蛋白clusterin在ALCL中也有较高的表达率,其可能在ALCL的发展中起作用,并对诊断和治疗具有潜在价值.本研究探讨ALCL中ALK及clusterin蛋白表达特点、相互关系及临床病理意义.方法：应用免疫组织化学EnVision法检测90例淋巴瘤组织中ALK及clusterin蛋白表达,其中包括47例ALCL及对照组周围T细胞淋巴瘤非特殊型（PTCL-u）22例,经典型霍奇金淋巴瘤（CHL）21例.结果：ALK在ALCL、PTCL和CHL中的阳性率分别为60%（28/47）、0和0;clusterin在三者中的阳性率分别81%（38/47）、27%（6/22）和14%（3/21）,ALK和clusterin在ALCL的阳性率均显著高于PTCL和CHL的阳性率（P＜0.05）,clusterin在ALK阴性的ALCL中的阳性率为68%（13/19）,也显著高于PTCL和CHL的阳性率（P＜0.05）.ALK阳性的ALCL中位年龄20岁（3～70岁）,显著低于ALK阴性者（P＜0.05）,阴性中位年龄48岁（4～71岁）,ALK阳性与否与发生部位、性别无关（P＞0.05）.clusterin的表达与否与年龄、部位和性别均无关（P＞0.05）.结论：ALK在ALCL中的特异性表达对其诊断、鉴别诊断并可能对临床预后判断具有重要价值.clusterin作为一新的分子标志物,在ALCL中的相对特异性高表达对ALCL的诊断、特别是对ALK阴性的ALCL与PTCL和CHL的鉴别诊断将具有重要意义.Background and purpose： Anaplastic lymphoma kinase （ALK） is a specific molecular marker in systemic anaplastic large cell lymphoma （ALCL）. Clusterin was a relatively new protein and recently found to have high expression in ALCL. It might play an important role in ALCL pathogenesis and have potential value in ALCL diagnosis and treatment. This study was done to investigate the expression of ALK and clusterin, and their clinicopathological significance in ALCL. Methods： The expression of ALK and clusterin was detected by immunohistochemistry using EnVision method in 90 lymphomas including 47 ALCL, 22 peripheral T-cell lymphoma, unspecified （PTCL-u） and 21 classical Hodgkin＇ s lymphoma （CHL）. Results： The expression of ALK were 60 % （28/47）, 0 and 0 in ALCL, PTCL and CHL, respectively. The expression of clusterin were 81% （38/47）, 27 % （6/22） and 14 % （ 3/21）, respectively. The expressions of both ALK and clusterin in ALCL were significantly higher than that in PTCL and CHL（ P 〈 0.05）. The expression of clusterin in those with ALK-negative ALCL was 68 % （ 13/19）, which was also significantly higher than that in both PTCL and CHL（P 〈 0. 05）. The mean age of ALK-positive ALCL patients was 20 years old （3-70） and was significantly younger than that of ALK- negative patients （ mean age： 48 ranged from 4 to 71） （P 〈 0.01）. There were no significant relationships among the expression of ALK and clusterin and lesion sites, gender（ P 〉 0.05）. Conclusions： The specific expression of ALK has great value in the diagnosis, differential diagnosis, and might have great value in terms of the prognosis for the patients with ALCL. Clusterin has relatively high expression in ALCL, and it will also be of significance for ALCL diagnosis, especially for the differential diagnosis between the patients with ALK-negative ALCL and PTCL and CHL.

关 键 词：CLUSTERIN ALK 间变性大细胞淋巴瘤 免疫组织化学 

分 类 号：R733.4[医药卫生—肿瘤]