儿童成熟B-NHL中BCL-2、BCL-6蛋白表达及其临床病理意义  

BCL-2 and BCL-6 protein expression in pediatric B-cell Non-Hodgkin' s lymphoma and its clinic-pathologic significance

作　　者：王舒静[1] 高怡瑾[1] 孟建华[1] 陆凤娟[1] 李军[1] 王宏胜[1] 翟晓文[1] 苗慧[1] 钱晓文[1] 俞懿[1] 

机构地区：[1]复旦大学附属儿科医院血液肿瘤科,上海201102

出　　处：《中国小儿血液与肿瘤杂志》2014年第2期69-72,共4页Journal of China Pediatric Blood and Cancer

基　　金：上海市卫生局项目(2010023)

摘　　要：目的初步探讨儿童成熟B细胞非霍奇金淋巴瘤(B-NHL)中BCL-2、BCL-6蛋白表达及其临床病理意义。方法收集1999-2011年复旦大学附属儿科医院血液科收治的92例初治儿童B-NHL资料,包括伯基特淋巴瘤(burkitl lymphoma,BL)53例,弥漫大B细胞性淋巴瘤(DLBCL)38例,以及介于BL与DLBCL之间未能分类的B细胞淋巴瘤(BL/DLBCL)1例。92例患儿年龄≤16岁。所有病例均经过2家三级甲等医院病理科诊断。通过免疫组织化学技术检测儿童B-NHL中BCL-2、BCL-6蛋白表达情况。结果 (1)92例儿童B-NHL中47例进行BCL-2蛋白检测,BCL-2表达阳性率在BL和DLBCL中分别为9.7%(3/31)和33.3%(5/15),差异具有统计学意义(P=0.047)。BCL-2蛋白表达与性别、临床分期及预后无相关性(P>0.05)。(2)31例儿童B-NHL进行BCL-6蛋白检测,BCL-6表达阳性组与阴性组2年EFS分别为83.3%和45.5%,差异有统计学意义(P=0.019);在临床分期为Ⅲ-Ⅳ期儿童B-NHL中,BCL-6阳性组与阴性组的2年EFS分别为80%和40%,2组差异具有统计学意义(P=0.023)。结论儿童B-NHL中BCL-2蛋白表达与病理类型有关,BL中BCL-2蛋白一般表达阴性,可用于BL与DLBCL之间的鉴别;儿童B-NHL中BCL-6表达阳性的患儿预后较好,提示BCL-6可能是B-NHL的预后因素之一。Objective The study was designed to investigate the protein expression of BCL-2 and BCL-6 in children with B-NHL and its clinic-pathological significance. Method Between July 1999 and October 2011,92 untreated patients （age 16 years or less） with newly diagnosed B-NHL （including BL, DLBCL and BL/DLBCL） were enrolled. We use the immunohistochemical technique （Envision TM） to detect BCL-2, BCL-6 protein expression levels. The expression of BCL-2 and BCL-6 and its association with clinic-pathological features and prognosis were analyzed. Results BCL-2 protein expression was performed in 47 B-NHL, the rate of positivity in BL and DLBCL were 9.7% （3/31） and 33.3% （5/15）, respectively. There was significant difference between them （P =0. 047）. However, there was no association between the expression of BCL-2 and gender, stage and prognosis （P 〉 0.05 ）. BCL-6protein expression was performed in 31 B-NHL, The 2-year EFS was 83.3% for children with BCL-6 protein expression, the other was 45.5%, there was significant differenee between them （P = 0. 019）. Children with positive BCL-6 protein expression had better prognosis. Conclusion BCL-2 protein expression was useful for distinguish BL from DLBCL and BCL-6 protein expression is a prognosis factor of B-NHL.

关 键 词：B细胞非霍奇金淋巴瘤 B细胞白血病 淋巴瘤-2 BCL-6基因 儿童 

分 类 号：R733.1[医药卫生—肿瘤]