梅州地区胃肠道B细胞淋巴瘤临床病理学研究  

Gastrointestinal B-cell lymphoma in Meizhou area: A clinicopathological study

作　　者：郑少秋[1] 罗敬[2] 朱文标[1] 陈会林[1] 谢寿城[1] 黄艳芳[1] 

机构地区：[1]广东省梅州市人民医院病理科,广东梅州514031 [2]广东省梅州市人民医院盆腔放疗科,广东梅州514031

出　　处：《广州医科大学学报》2017年第2期75-78,共4页Academic Journal of Guangzhou Medical University

摘　　要：目的:探讨梅州地区胃肠道B细胞淋巴瘤的临床特征、分类特点及病理诊断。方法:对120例胃肠道原发B细胞淋巴瘤的临床资料、组织学形态、免疫表型进行分析,内容包括:患者年龄、性别、发病部位、内镜表现或手术切除大体形态、组织学形态、免疫组织化学(En Vision法)进行CD20、CD2、CD5、Bcl2、Bcl6、CD10、Cyclin-D1、Mum-1、Ki67染色。结果:患者年龄2.5-95岁(中位年龄52岁),男女比为1.2∶1;发病部位位于胃61例(50.83%),小肠16例(13.33%),回盲部4例(3.33%),盲肠15例(12.50%),结肠18例(15.00%),直肠6例(5.00%);内镜表现或手术切除标本呈息肉/结节/菜花状27例(22.50%),糜烂18例(15.00%),溃疡75例(62.50%);病理分类DLBCL 59例(49.17%),MALT 43例(35.83%),MCL10例(8.33%),Burkitt淋巴瘤7例(5.83%),FL 1例(0.83%);所有病例均表达CD20、不表达CD2,不同程度表达CD5、Bcl2、Bcl6、CD10、Cyclin-D1、Mum-1、Ki67。结论:梅州地区胃肠道B细胞淋巴瘤男性发病略高于女性(男女比为1.2∶1),胃肠发病比例差异不明显(胃61例,肠59例),肠道B细胞淋巴瘤最常见于结肠、盲肠;病理分类最常见为DLBCL及MALT,其次为MCL和Burkitt,极少见FL;MCL和FL大体表现为息肉状肿物,MALT主要表现为黏膜糜烂及小溃疡,DLBCL主要表现为溃疡,且较MALT所见溃疡体积大,肿瘤的大体表现对分类有提示作用;结合大体所见、HE形态及免疫表型能对绝大部分胃肠道B细胞淋巴瘤做出正确诊断及分类。Objective：To investigate the clinical characteristics, classification and pathological diagnosis of gastrointestinal B-cell lymphoma in Meizhou area. Methods： The clinical data, histological morphology and immunophenotype of 120 cases of primary gastrointestinal B-cell lymphoma were analyzed, including the age, gender,pathogenic sites, endoscopic manifestation or general morphology of surgical resection, and histological morphology. Immunohistochemistry （EnVision） was used for staining of CD20, CD2, CD5, Bcl2, Bcl6, CD10, Cyclin-D1 ,Mum-1 and Ki67. Results： The age of patients ranged from 2.5 to 95 years old （median age of 52 years old）, and the male to female ratio was 1.2：1. The pathogenic sites frequently involved stomach （n = 61, 50.83% ）, small intestine （ n = 16,13.33% ） , ileocecal junction （ n = 4,3.33 % ）, cecum （ n = 15,12.50% ）, colon （n = 18, 15%） and rectum （n = 6, 5%）. There were 27 cases of polyp/nodule/cauliflower-like endoscopic manifestation or surgical resection specimens （22.50%）, 18 of erosion （15.00%） ,and 75 of ulcer （62.50%）. The pathological classification showed that there were 59 cases of diffuse large B-cell lymphoma （ DLBCL ） （49.17%） ,43 of mucosa-associated lymphoid tissue extranodal marginal zone B-cell lymphoma （MALT） （35.83%）, 10 of mantle cell lymphoma （MCL） （8.53%） ,7 of Burkitt lymphoma （5.83%） ,and 1 of Follicular lymphoma （FL） （0.83%）. All the cases expressed CD20,whereas did not express CD2,and expressed CD5, Bc12, Bc16, CD10, Cyclin-D1, Mum-l, and Ki67 in different degrees. Conclusion： The incidence of gastrointestinal B-cell lymphoma in male is slightly higher than that in female in Meizhou area （ male to li, male ratio 1.2 ： 1 ）. There is no significant differenee in the incidence rate of gastrointestinal diseases （ 61 cases of stomach,59 cases of intestine）. The intestinal B-cell lymphoma is most common in colon and cecum. DLBCL and MALT are the most common pathologieal c

关 键 词：胃肠肿瘤 淋巴瘤 B细胞 免疫组化 诊断 

分 类 号：R733[医药卫生—肿瘤]