黏膜相关淋巴组织淋巴瘤分子病理诊断探讨  

Molecular Pathological Diagnosis of Mucosa-associated Lymphoid Tissue Lymphoma

作　　者：张建锋[1] 张曙霞[1] 李君[2] 

机构地区：[1]嵊州市人民医院病理科,浙江嵊州312400 [2]浙江大学附属第一医院病理科,浙江杭州310003

出　　处：《中国实验血液学杂志》2015年第3期689-692,共4页Journal of Experimental Hematology

摘　　要：目的:分析黏膜相关淋巴组织淋巴瘤(mucosa-associated lymphoid tissue lymphoma,MALTL)的分子病理诊断结果。方法:回顾性分析60个MALTL石蜡包埋标本的原发病灶部位分布、形态学、免疫表型以及免疫球蛋白重链(Ig H)基因克隆性重排情况。结果:MALTL患者主要发病部位为胃部(37%),其次为唾液腺(20%),第三为肠(12%)、眼眶及眼附属器(12%);低倍镜下MALTL标本多数表现为弥漫性生长,少数表现为结节样结构,淋巴瘤细胞形态呈多样化;免疫组织化学结果显示CD20,而BCL-2均呈阳性,CD3、CD5、CD10、CD23、cyclin D1和CD21均呈阴性,17个标本kappa或lambda的表达具有优势,敏感性为28.33%(17/60);61.67%(37/60)发生Ig H基因单克隆性重排,19个标本Ig H基因单克隆性重排与kappa或lambda均为阴性,两者联合检测阳性率占68.33%。结论:组织形态学特点和免疫组织化学检测均为诊断M ALTL的基本手段,Ig H基因重排及kappa或lambda限制性表达的检测在MALTL诊断中有重要意义,二者联合检测的阳性率更高。Objective： To explore the molecular pathological diagnosis of mucosa-associated lymphoid tissue lymphoma（MALTL）. Methods： Sixty MALTL paraffin embedding specimens were analyzed retrospectively. The distribution of the primary lesion, morphology, immunophenotype, IgH gene cloning rearrangement were evaluated. Results：The main risk area for the patients with MALTL was gastric area（37% ）, in the second place was salivary gland（20% ）, in the third place was intestine （12%） , orbit and ocular adnexa（ 12% ） ; at low magnification, MALTL specimens manifasted diffuse growth majority, a few of nodular structure, lymphoma cell forms were diversified; The results of immunohistochemical detection showed that the CD20 and the BCL-2 were positive, the CD3, CD5, CD10, CD23, cyclin D1 and CD21 were negative, 17 specimen kappa or lambda express more obviously, their sensibility was 28. 33% （17/60）; 61.67% （37/60） developed IgH gene rearrangement, 19 specimen IgH gene rearrangement monoclonal and kappa or lambda were negative, the positive rate of both combined detections was 68.33%. Conclusion： The tissue morphologic characteristics and immuno-histochemistry detection are the basic means for MALTL diagnosis, the detection of IgH gene reasragement and Kappa or lamda restrictive expression has the practical importance for MALTL diagnosis, both combination can show higher positive rate for MALTL diagnosis.

关 键 词：淋巴瘤 黏膜相关淋巴组织淋巴瘤 分子病理诊断 

分 类 号：R733.1[医药卫生—肿瘤]