睾丸原发性弥漫大B细胞淋巴瘤中EZH2蛋白的表达及其意义  

Expression and significance of EZH2 protein in primary testicular diffuse large B cell lymphoma

作　　者：马世荣[1,2] 王映梅[1,2] 刘杨[2] 郭双平[1,2] 

机构地区：[1]第四军医大学病理学教研室,西安710032 [2]第四军医大学西京医院病理科,西安710032

出　　处：《临床与实验病理学杂志》2017年第5期485-489,共5页Chinese Journal of Clinical and Experimental Pathology

基　　金：国家自然科学基金(81472597)

摘　　要：目的探讨睾丸原发性弥漫大B细胞淋巴瘤(diffuse large B cell lymphoma,DLBCL)中EZH2蛋白的表达、临床病理特征及意义。方法采用免疫组化Ventana Ultra View两步法检测17例睾丸原发性DLBCL中EZH2蛋白的表达,并结合文献分析其病理形态、诊断及鉴别诊断。采用Sanger法检测EZH2 641位点酪氨酸(Y641)突变。结果 11例肿瘤细胞类似中心母细胞,3例肿瘤细胞类似免疫母细胞,3例肿瘤细胞具有间变亚型特点。免疫组化标记显示14例为非生发中心B细胞样(non germinal centre B cell like,non-GCB)型,3例为生发中心B细胞样(germinal centre B cell like,GCB)型;其中15例肿瘤细胞核强阳性表达EZH2蛋白,2例约70%肿瘤细胞核中等强度表达EZH2蛋白;未检测到EZH2 Y641点突变。随访9例患者,中位生存时间35个月,EZH2蛋白的表达与患者预后无相关性。结论睾丸原发性DLBCL属于少见的非霍奇金淋巴瘤,具有独特的临床病理学特征,绝大部分为non-GCB型;EZH2蛋白在睾丸原发性DLBCL过表达,其有望成为肿瘤诊断及治疗的新靶点。Purpose To explore the expression and significance of histone methyhransferase EZH2, clinicopathological features in primary testicular diffuse large B-cell lymphoma （DLBCL）. Methods Immunohistochemical of Ventana Ultra View two-step staining was used to detect expression of EZH2 in 17 cases of primary testicular DLBCL. The relationship between EZH2 expression and its clinicopathological features were analyzed. Sanger squencing was used to detect EZH2 Y641 mutation in these cases. Results Morphologically, the tumor cells resembled centroblasts in 11 cases, immunoblasts in 3 cases, and anaplastic variants in 3 cases. Immunophenotypically, 14 cases were non-germinal centre B cell like （non-GCB） type and 3 cases were germinal centre B cell like （GCB） subtype. EZH2 overexpressed in all 17 cases. EZH2 overexpressed in nearly tumor cells with uniformly strong intensity in 15 cases, and more than 70% tumor cells with moderate to strong intensity in 2 cases. The follow-up information was obtained in 9 patients, with a median survival time of 35 months. No association was found between the level of EZH2 expression and outcome of patients. No mutation of EZH2 Y641 was detected. Conclusion Primary testicular DLBCL is a rare aggressive B cell lymphoma with distinctive clinicopathological features. Detection of EZH2 expected to assist in the diagnosis and treatment of tumor.

关 键 词：睾丸原发性弥漫大B细胞淋巴瘤 EZH2 临床病理学特征 免疫表型 预后 

分 类 号：R737.21[医药卫生—肿瘤]