bcl-10蛋白异常表达对黏膜相关淋巴组织结外边缘区B细胞淋巴瘤的诊断价值  

Abnormal expression of bcl-10 protein in extranodal marginal zone B cell lymphoma of mucosa-associated lymphoid tissue lymphoma type

作　　者：李百周[1] 周晓燕[1] 叶洪涛[2] 杨文涛[1] 范月珍[1] 陆洪芬[1] 施达仁[1] 

机构地区：[1]复旦大学附属肿瘤医院病理科,复旦大学上海医学院肿瘤学系200032 [2]广西医科大学病理学教研室

出　　处：《中华病理学杂志》2007年第12期819-824,共6页Chinese Journal of Pathology

摘　　要：目的探讨 bcl-10蛋白表达对黏膜相关淋巴组织结外边缘区 B 细胞淋巴瘤(MALT 淋巴瘤)的诊断价值。方法收集140例不同部位的 MALT 淋巴瘤,包括胃38例、眼眶35例、肠16例、皮肤15例、涎腺15例、肺14例、甲状腺3例、其他部位4例。对照:10例扁桃体反应性滤泡增生(RFH)、5例眼眶的淋巴组织增生和143例非 MALT 淋巴瘤、不同类型的非霍奇金淋巴瘤(NHL),包括20例 NK/T 细胞淋巴瘤、20例滤泡性淋巴瘤(FL)、20例间变性大细胞淋巴瘤(ALCL)、20例淋巴结内弥漫大 B 细胞淋巴瘤(DLBCL)、10例原发胃 DLBCL、13例淋巴结边缘区淋巴瘤(NMZL)、12例套细胞淋巴瘤(MCL)、11例脾脏边缘区淋巴瘤(SMZL)、6例血管免疫母细胞性 T 细胞淋巴瘤(AITL)、6例外周 T 细胞淋巴瘤(PTCL)、3例 B-小淋巴细胞淋巴瘤(B-SLL)、1例淋巴浆细胞性淋巴瘤(LPL)和1例浆细胞瘤。免疫组织化学 EnVision 法检测 bcl-10蛋白;免疫组织化学双标记法检测CD20与 bcl-10的共表达。结果在扁桃体 RFH 中,bcl-10蛋白呈中等强度表达于生发中心 B 细胞质中,套细胞不表达,边缘区细胞和副皮质区 T 细胞呈弱表达。在眼眶淋巴组织增生中,2例 bcl-10阴性,3例主要呈淋巴滤泡生发中心 B 细胞质阳性,与扁桃体 RFH 的表达类似。在非 MALT 淋巴瘤的其他类型 NHL 中,除3例(3/10)原发胃 DLBCL 呈胞核阳性外,其余均未见胞核表达;在不同 NHL中的胞质阳性分别为:结内(12/20)和胃(7/10)DLBCL、FL 和 ALCL(16/20)、PTCL(5/6)、AILT(6/6)、NMZL(13/13)、SMZL(11/11)、B-SLL(3/3)和浆细胞瘤(1/1),11例 MCL 呈胞质可疑阳性,20例 NK/T 细胞淋巴瘤和1例 LPL 阴性;在部分淋巴瘤中可见肿瘤性细胞表达而反应性小淋巴细胞不表达:MALT 淋巴瘤之 bcl-10的总表达率为92.1%(129/140),其中54.3%(76/140)胞质阳性,37.9%(53/140)胞核阳性;但不同部位之胞核阳性率有所不同。在 MALT 淋巴瘤中,bcl-10蛋白核强表达最常见于眼眶(25.7%,9/35);Objective To evaluate the diagnostic role of nuclear expression of bcl-10 protein in extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue （MALT） type. Methods One hundred and forty cases of MALT lymphoma were collected from Cancer Hospital of Fudan University （including 38 cases from stomach, 35 cases from ocular adnexa, 16 cases from intestine, 15 cases from skin, 15 cases from salivary gland, 14 cases from lung, 3 cases from thyroid and 4 cases from other sites）. Ten eases of reactive follicular hyperplasia of tonsil, 5 eases of reactive lymphoid hyperplasia of orbit and 143 eases of non-Hodgkin＇s lymphoma other than MALT lymphoma （ including 20 eases of NK/T cell lymphoma, 20 eases of follicular lymphomas, 20 eases of anaplastie large cell lymphomas, 20 eases of nodal diffuse large cell B-cell lymphoma （DLBCL） , 10 eases of gastric diffuse large B-cell lymphoma, 13 eases of nodal marginal zone B-cell lymphoma, 12 eases of mantle cell lymphoma, 11 eases of splenic marginal zone B-cell lymphoma, 6 eases of angloimmunoblastie T-cell lymphoma, 6 eases of peripheral T-cell lymphoma, not otherwise specified, 3 eases of small lymphocytic lymphoma, 1 ease of lymphoplasmaeytie lymphoma and 1 ease of plasmaeytoma were used as controls. Immunohistoehemieal study for bcl-10, as well as dual staining with CD20, was performed by EnVision method in paraffin sections. Results In reactive follicular hyperplasia of tonsil, bcl-10 was moderately or strongly expressed in the cytoplasm of germinal center B cells, while the mantle cells were negative and the marginal zone cells and paracortical T cells showed weak staining. In the 5 cases of reactive lymphoid hyperplasia of orbit, 2 were bcl-10-negative and the remaining 3 expressed bcl-10 in the cytoplasm of germinal center B cells. As for non-MALT lymphomas, 3 gastric DLBCL showed nuclear expression. The remaining cases showed variable cytoplasmic staining. In some cases of lymphoma, bcl-10 was expressed in tumor cells but not in reactive

关 键 词：淋巴瘤 黏膜相关淋巴样组织 蛋白质bcl-10 诊断 鉴别 

分 类 号：R733.1[医药卫生—肿瘤]