弥漫性大B细胞淋巴瘤C-MYC、BCL2基因异常的临床病理分析  

Study on the relationship between clinical pathological and gene abnormalities of MYC,BCL-2 in diffuse large B-cell lymphoma

作　　者：何银珠[1] 陈宝珍[1] 王晓江[1] 师怡[1] 陈芳芳 陈燕坪[2] HE Yin-zhu;CHEN Bao-zhen;WANG Xiao-jiang;无(Department of Molecular pathyology,Fujian Cancer Hospital&Fujian Medical University Cancer Hospital,Fuzhou,350104 China;Department of pathyology,Fujian Cancer Hospital&Fujian Medical University Cancer Hospital,Fuzhou,350104 China)

机构地区：[1]福建省肿瘤医院,福建医科大学附属肿瘤医院分子病理室,福建福州350104 [2]福建省肿瘤医院,福建医科大学附属肿瘤医院病理科,福建福州350104

出　　处：《吉林医学》2020年第7期1545-1549,共5页Jilin Medical Journal

基　　金：福建省卫生计生委青年课题[项目编号:2017-1-16];福建省卫生计生委中青年骨干人才项目[项目编号:2018-ZQN-15]。

摘　　要：目的:探讨C-MYC、BCL2基因在弥漫性大B细胞淋巴瘤的易位情况及临床意义。方法:收集2015年10月~2019年1月福建省肿瘤医院病理科确诊的弥漫性大B细胞淋巴瘤患者42例,采用免疫组织化学检测C-MYC、BCL2蛋白表达情况,利用荧光原位杂交(FISH)检测两个基因的易位情况,并分析其与临床病理的关系。结果:42例弥漫性大B细胞淋巴瘤患者中26例(61.90%)同时高表达C-MYC、BCL2蛋白;C-MYC基因异常13例(8例基因易位,5例拷贝数增加),BCL2基因异常12例(4例基因易位,7例拷贝数增加,1例易位伴拷贝数增加);2例c-myc基因易位伴BCL2基因易位;BCL2基因易位更倾向发生在高临床分期、高ECOG评分及乳酸脱氢酶(LDH)升高的病例中。结论:弥漫性大B细胞淋巴瘤存在着多种分子异常,双重打击在弥漫性大B细胞淋巴瘤的检出率为4.76%(2/42);BCL2基因易位与临床分期、ECOG评分、LDH相关,蛋白高表达不能作为筛选基因异常的指标。Objective To explore the gene abnormalities of myc,BCL2 in diffuse large b-cell lymphoma and their correlation prognosis.Method 42 cases diagnosed with diffuse large b-cell lymphoma from October 2015 to January 2019 were collected.The expression of C-MYC,BCL2 was analyzed by immunohistochemistry.Interphase fluorescence in situ hybridization(I-FISH)analysis was performed to identify the genetic alteration of C-MYC,BCL2.Results In all cases,Concurrent high expression of C-MYC and BCL2 were presented in 26 cases(61.90%).13 cases of C-MYC gene abnormality(8 cases of gene translocation,5 cases of copy number increase),12 cases of bal 2 gene abnormality(4 cases of gene translocation,7 cases of copy number increase,1 case of copy number increase);Two cases of C-MYC gene translocation and BCL2 gene translocation;BCL2 gene rearrangement suggest high clinical staging,high ECOG score,high lactate dehydrogenase(LDH).Conclusion The proportion of diffuse large b-cell lymphoma with double-hit lymphoma is 4.76%(2/42)in this study.Bcl-2 gene rearrangement was related with clinical staging,ECOG score,lactate dehydrogenase(LDH)in diffuse large b-cell lymphoma.Protein expression level cannot serve as screening index of genetic abnormality.

关 键 词：淋巴瘤 大B细胞 C-MYC BCL2 基因异常 

分 类 号：R733.1[医药卫生—肿瘤] R730.43[医药卫生—临床医学]