bcl-10蛋白在MALT淋巴瘤中的表达

Expression of bcl-10 protein in MALT lymphoma

目的观察bcl-10蛋白在黏膜相关淋巴组织样结外边缘区B细胞淋巴瘤(MALT淋巴瘤)中的表达及其意义。方法对62例MALT淋巴瘤进行回顾性研究,采用免疫组织化学SP法检测bcl-10及Ki-67的表达。结果62例MALT淋巴瘤中,60例(96·8%)表达bcl-10,其中胞核和胞质同时表达33例(53·2%),仅有胞质表达27例(43·6%)。10例桥本甲状腺炎bcl-10均表达于胞质。bcl-10核阳性组发病平均年龄(51·4岁)比bcl-10核阴性组(56·6岁)小5·2岁,bcl-10核阳性组以男性占优势,bcl-10核阴性组以女性发病较多。不同解剖部位核阳性表达率差异有统计学意义(P<0·05),肺和胃肠道检出率较高,而甲状腺较少;不同临床分期之间核阳性表达率差异P>0·05;bcl-10核表达与不表达两组在肿瘤细胞形态上差异P>0·05;在胃肠道40例病例中,不同浸润组别的核阳性率表达差异P<0·05,浸出浆膜外的病例核阳性率高于局限在浆膜以内的病例;bcl-10核阳性组与核阴性组Ki-67增殖指数的差异无统计学意义。随访52例(83·9%),bcl-10核阳性组(29例,96·3%)与核阴性组(23例,66·4%)的5年生存率差异无统计学意义。结论bcl-10在MALT淋巴瘤中主要有胞质和胞核两种表达模式;胞核的表达在不同解剖部位之间检出率不同,并与肿瘤的浸润深度相关。bcl-10在MALT淋巴瘤的诊断、治疗和预后方面有一定的提示作用。

Objective To investigate the significance of bcl-10 protein expression in extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue （MALT） lymphoma, Methods Sixtytwo cases of MALT lymphoma were reviewed and immunohistochemical studies for bcl-10 and Ki-67 were performed. Results Sixty out of the 62 cases studied （96. 8% ） were positive for bcl-10. Thirty-three （53.2%） showed bcl-10 expression in both the nuclei and cytoplasm, while 27 cases （43.6%） showed only cytoplasmic staining. The 10 cases with Hashimoto＇s thyroiditis demonstrated bcl-10 expression in the cytoplasm. The mean age of patients with bcl-10 nuclear expression （51.4 years old） was 5.2 years younger than those （56. 6 years ） without bcl-10 nuclear expression. The former category also showed a male predilection （male to female ratio = 19： 14, in contrast to 10：19 in the latter category）. The frequency of bcl-10 nuclear expression was lower in cases from thyroid but higher in cases from lung, stomach and intestine （P 〈 0. 05）. There was no statistically significant correlation between bcl-10 nuclear expression and clinical tumor stage （ P 〉 0. 05 ） or tumor cell morphology （ P 〉 0. 05 ） . Amongst the 40 cases of gastrointestinal MALT lymphoma, bcl-10 nuclear expression correlated with extent of tumor involvement. The protein was expressed in 36. 4% （4 out of 11 cases） of MALT lymphoma confined to mucosa or submucosa, 65.2% （15 out of 23 cases） of those invading down to muscularis propria or subserosa, and 100% （all 6 cases） of those extending beyond serosa （ P 〈 0. 05 ）. There was no statistically significant difference in Ki- 67 proliferative index between bcl-10-positive and bcl-10-negative groups （ P 〈 0. 05 ）. Follow-up data were available in 52 patients （83.9%） and the five-year survival rate was no statistically significant difference in survival between bcl-10-positive （29 patients, 96. 3% ） and bcl-10-negative groups （23 patients, 66. 4% , P 〉0. 05）. Conclusions Two expression patterns of bcl-10 protein were observed in MALT lymphoma： mixed nuclear-cytoplasmic and cytoplasmic only. The bcl-10 nuclear expression appears more important and correlates with anatomic site of tumor and extent of tumor involvement. Immunohistochemical detection of bcl-10 may carry some diagnostic and prognostic implications in assessment of MALT lymphoma.