c-myc在间变性大细胞淋巴瘤中的表达及其意义  

Expression of c-myc in anaplastic large cell lymphoma and its significance

作　　者：柴菲[1] 陈振文[1] 郗彦凤[2] 孙瑞芳[2] 白玮[2] 李静[2] 徐义荣[1] 

机构地区：[1]山西医科大学汾阳学院病理教研室,汾阳032200 [2]山西省肿瘤医院病理科

出　　处：《白血病．淋巴瘤》2015年第4期238-244,共7页Journal of Leukemia & Lymphoma

基　　金：山西省自然科学基金（2012011038-4、2011011038-1）

摘　　要：目的 探讨c-myc在系统性间变性大细胞淋巴瘤（ALCL）中蛋白表达和基因异常与临床病理特征、免疫组织分型的关系.方法 选取ALCL患者87例,应用免疫组织化学EnVision法检测c-mvc、间变性淋巴瘤激酶（ALK）、CD3、CD10、CD20、CD30、EMA的蛋白表达情况;应用荧光原位杂交（FISH）技术检测c-myc和ALK基因异常情况;统计分析c-myc蛋白表达和基因异常与各临床病理参数间的关系.结果 免疫组织化学结果：87例ALCL中,ALK阳性者54例（62.1％）,c-myc阳性者27例（31.0％）,c-myc和ALK蛋白联合表达20例（23.0％）.c-myc蛋白表达率、c-myc和ALK蛋白联合表达率随ALCL临床分期的增加而升高,且在国际预后指数（IPI）高危组中表达率高于低危组（P＜0.05）.FISH检测结果：87例ALCL中,50例（57.5％）发现ALK基因的易位,19例（21.8％）发现ALK基因的多拷贝.所有患者均未发现c-myc基因的易位,但19例（21.8％）检测到c-myc基因的多拷贝.c-myc基因多拷贝的发生率在ALK蛋白阳性和阴性组中差异无统计学意义（P＞0.05）,在c-myc蛋白阳性和阴性组中发生率差异有统计学意义（P＜0.05）,在IPI高危组中发生率高于低危组（P＜0.05）.结论 c-myc蛋白表达及基因异常与ALCL临床分期、IPI相关,可作为判断ALCL恶性程度和预测预后的指标.Objective To investigate the protein expression and genetic alterations of c-myc in primary systemic anaplastic large cell lymphoma （ALCL） and discuss its relationship with clinicopathologic features and immunophenotypes.Methods 87 cases of ALCL were selected.Immunohistochemical method was used to detect the protein expression of c-myc,ALK,CD3,CD10,CD20,CD30 and EMA.c-myc and ALK genetic alterations were detected by using fluorescence in situ hybridization （FlSH）.The interrelationships between protein expression,genetic alterations and clinicopathological parameters were analysed statistically.Results Immunohistochemical results：of 87 cases,ALK protein was expressed in 54 cases （62.1%）.c-myc protein was expressed in 27 cases （31.0 %）.ALK and c-myc were co-expressed in 20 cases （23.0 %）.c-myc protein expression,ALK and c-myc co-expression increased with the upgrade of ALCL clinical stages,and the expression was higher in International Prognostic Index （IPI） high-risk groups than in low-risk groups （P 〈 0.05）.FISH test results：of 87 ALCL cases,there were 50 cases （57.5 %） of ALK rearrangements and 19 cases （21.8 %） of ALK aneuploidy.c-myc rearrangement was detected in none of 87 ALCL cases,but there was aneuploidy in 19 cases （21.8 %）.The differences of c-myc aneuploidy in ALK positive and negative groups were statistically insignificant （P 〉 0.05）,while they were statistically significant in c-myc groups （P 〈 0.05） and in different IPI groups （P 〈 0.05）.Conclusion c-myc protein expression and aneuploidy were related with ALCL clinical stages and IPI,which could be used as an indicator of estimating ALCL malignant degree and predicting prognosis.

关 键 词：间变大细胞淋巴瘤 免疫组织化学 荧光原位杂交 

分 类 号：R733.1[医药卫生—肿瘤]