原发性中枢神经系统弥漫性大B细胞淋巴瘤主要为活化B细胞亚型  

Primary diffuse large B-cell lymphoma of central nervous system belongs to activated B-cell-like subgroup： a study of 47 cases

作　　者：程静 涂频[1] 石群立[1] 周航波[1] 周志毅[1] 赵有财[1] 马恒辉[1] 周晓军[1] 

机构地区：[1]南京大学医学院南京军区南京总医院病理科,210002 [2]无锡市妇幼保健医院病理科

出　　处：《中华病理学杂志》2008年第6期384-389,共6页Chinese Journal of Pathology

摘　　要：目的对原发性中枢神经系统弥漫性大B细胞淋巴瘤分型，并探讨其组织起源和预后相关意义。方法应用免疫组织化学EnVision二步法，检测CD10、bc1-6、MUM-1、CD138和FOXP1在47例原发性中枢神经系统弥漫性大B细胞淋巴瘤中的表达情况。结果CD10、bcl-6、MUM-1、CD138和FOXP1表达率分别为6．4％、53．2％、91．5％、0和93．6％。47例中有43例（91．5％）为活化B细胞表型：21例（44．7％）为活化的生发中心亚型，22例（46．8％）为活化的非生发中心亚型。该分型及FOXP1的表达与预后无明显相关性（P=0．279和P=0．154）。结论原发性中枢神经系统弥漫性大B细胞淋巴瘤绝大多数为活化B细胞亚型，是系统性弥漫性大B细胞淋巴瘤中一种相对同质性的亚型，推测其组织起源是生发中心末期至后生发中心早期的B细胞。Objective To investigate the histogenetic origin of primary central nervous system diffuse large B-cell lymphoma （DLBCL） with respect to the stage of B-cell differentiation, and identification of the relevant prognostic markers. Methods Immunohistochemical staining （ EnVision method） for CD10, bcl-6, MUM-1, CD138 and FOXP1 antigens was performed on 47 paraffin-embedded sections. Results CD10, bcl-6, MUM-1 and FOXP1 expression in the tumor cells were 6. 4% , 53.2%, 91.5% and 93.6% respectively. There was no expression of CD138 in all the cases. Among the 47 patients, 43 cases （91.5%） showed an activated B-cell-like （ABC） phenotype： 21 （44. 7% ） were bcl-6 ^＋ and MUM-1 ^＋ , suggesting an ＂activated germinal center （GC） B-cell-like＂ in origin; 22 （46. 8% ） were exclusively MUM-1^＋ , suggesting an ＂activated non-GCB＂ in origin. No significant correlation of the classification and FOXP1 expression found on the outcome （P =0. 279 and P =0. 154）. Conclusions Most primary central nervous system DLBCL are shown belonging to the ABC subgroup, suggesting that primary central nervous system DLBCL is quite similar to a DLBCL subset, which is derived from late GC to early post-GC B cell. The classification and FOXP1 expression do not show prognostic value in primary central nervous system DLBCL.

关 键 词：中枢神经系统肿瘤 淋巴瘤 B细胞 预后 

分 类 号：R686[医药卫生—骨科学]