原发性胃淋巴瘤凋亡抑制蛋白2-黏膜相关淋巴瘤转位基因1融合基因检测的意义  

The clinical value of apoptosis protein 2-mucosa associated lymphoid tissue lymphoma translocation gene 1 fusion gene detection in tissue of primary gastric lymphoma

作　　者：许国强[1] 陈妙辉[1] 陈洪潭[1] 单国栋[1] 胡凤玲[1] 杨铭[1] 

机构地区：[1]浙江大学医学院附属第一医院消化科,杭州

出　　处：《中华消化杂志》2011年第8期540-544,共5页Chinese Journal of Digestion

基　　金：卫生部科学研究基金浙江省医药卫生重大科技计划项目（WKJ-2009-2-021）

摘　　要：目的研究原发性胃淋巴瘤（PGL）内镜活检组织中凋亡抑制蛋白2-黏膜相关淋巴瘤转位基因1（APl2-MALT1）融合基因检测的可行性，探讨该融合基因在PGL的表达及其在PGL诊断、治疗等方面的临床价值。方法对32例疑诊为PGL者进行超声内镜检查和黏膜活检，活检标本分别进行组织病理、免疫组织化学检查和用荧光定量RTPCR测定APl2-MALT1融合基因。总结、分析诊断明确的PGL中APl2-MALT1融合基因的表达以及该融合基因与PGL诊断、分型和治疗等方面的关系。结果32例疑诊PGL者中14例经病理检查和免疫组织化学检查确诊为PGL，其中胃黏膜相关淋巴组织（MAI，T）淋巴瘤11例，胃弥漫性大B细胞淋巴瘤（DLBCL）3例。APl2-MALT1融合基因检测阳性5例，均为胃MALT淋巴瘤，约占胃MALT淋巴瘤（5／11）的45％。3例DLBCL患者APl2-MALT1融合基因检测均阴性。APl2-MALT1融合基因阴性组病变浸润深度和淋巴结浸润状况较阳性组严重。5例APl2-MALT1融合基因阳性者中幽门螺杆菌（Hp）阳性2例，9例阴性者中Hp阳性5例。APl2-MALT1融合基因阳性组5例行抗Hp治疗皆无效，但化学治疗有效；阴性组中5例Hp阳性者完全缓解2例，4例Hp阴性者抗Hp治疗无效。结论APl2-MALT1融合基因是胃MALT淋巴瘤的常见遗传学异常。内镜定位活检标本通过荧光定量PCR法检测该融合基因在临床上是可行的，该融合基因的检测对PGL诊断、治疗和预后评估均有一定的价值。Objective To explore the feasibility of inhibitor of apoptosis protein 2-mucosa associated lymphoid tissue lymphoma translocation gene 1 （API2-MALT1） fusion gene detection in endoscopic biopsy tissue of primary gastric lymphoma （PGL）, and to study the expression of this fusion gene in PGL and its clinical values in diagnosis and treatment of PGL. Methods A total of 32 suspicious PGL patients underwent endoscopic ultrasonography （EUS） examination and mucosal biopsy. The biopsy specimens were conducted histopathology examination, immunohistoehemistry detection and real time RT-PCR for API2 MALT1 MALT1 fusion gene in clearly diagnosed PGL and treatment were analyzed and summarized. Results fusion gene expression. The expression of API2- its relation with PGL diagnosis, classification and A total of 14 cases of 32 suspicious PGL patients were diagnosed as PGL by histopathology and immunohistochemistry examination, which including 11 cases of gastric mucosa-associated lymphoid tissue （MALT） lymphoma and 3 cases of gastric diffuse large B-cell lymphoma （DLBCL）. There were 5 API2-MALT1 fusion gene positive cases, which were all MALT lymphoma, about 5 out of total 11 MALT lymphoma patients. API2-MALT1 fusion gene expression was negative in all 3 gastric DLBCL cases. The depth of lesion invasion and lymph nodes metastasis were more severe in API2-MALT1 fusion gene negative group than those of positive group. There were 2 of 5 API2-MALT1 fusion gene positive cases were Hp positive, and 5 of 9 negative cases were Hp positive. The anti-Hp therapy in 5 API2-MALT1 fusion gene positive cases was ineffective, however, chemotherapy was effective. In negative group, 2 of 5 Hp positive cases was complete remission and 4 Hp negative cases were ineffective with anti-Hp therapy. Conclusions API2-MALT1 fusion gene is common genetic abnormality in gastric MALT lymphoma. The detection of this fusion gene expression in endoscopic biopsy specimen by real time RT-PCR is clinically practical, and the detection of this fus

关 键 词：胃肿瘤 淋巴瘤 癌基因蛋白质类 融合 活组织检查 聚合酶链反应 预后 

分 类 号：R735.2[医药卫生—肿瘤]