155例非霍奇金淋巴瘤患者细胞遗传学分析

Cytogenetic study on 155 cases of non-Hodgkin's lymphoma

目的了解非霍奇金淋巴瘤(NHL)患者染色体异常与 WHO 病理组织分型之间的关系,并与国外 NHL 染色体异常类型进行比较。方法采用常规染色体 G 带分析和荧光原位杂交(FISH)方法对155例 NHL 患者的淋巴结组织进行细胞和分子遗传学研究。结果 155例 NHL 患者中常见的病理类型是弥漫大 B 细胞淋巴瘤(DLBCL)(59例,38.1%)、滤泡性淋巴瘤(27例,17.4%)、B 小淋巴细胞淋巴瘤(16例,10.3%)、非特指周围 T 细胞淋巴瘤(13例.8.4%)、血管免疫母细胞性 T细胞淋巴瘤(11例,7.1%)。155例 NHL 患者中染色体异常为119例,占76.8%。滤泡性淋巴瘤、B 小淋巴细胞淋巴瘤、DLBCL、间变性大细胞淋巴瘤和前体 T 淋巴母细胞淋巴瘤染色体异常率较高,分别为96.3%、87.5%、86.4%、83.3%、83.3%。DLBCL 中复杂核型占86.3%,染色体结构异常累及最多的是3,6,14,1号染色体,41.2%为3q27异常,43.1%的病例有1号染色体异常。6q21、6q23和6q25异常占23.5%。DLBCL 中典型 t(14:18)的病例只有2例,明显低于国外报道。用 FISH 方法检测 DLBCL中 IgH 重排阳性率为40.1%。16例 B 小淋巴细胞淋巴瘤均未发现13q14缺失,只发现2例有13q10异常。11例血管免疫母细胞性 T 细胞淋巴瘤中只有3例核型异常。结论我国淋巴瘤的病理类型分布与欧美国家有明显不同。尽管 DLBCL 染色体异常类型基本与国外相似,但 t(14;18)较少见。与国外报道相比,B 小淋巴细胞淋巴瘤和血管免疫母细胞性 T 细胞淋巴瘤染色体异常率较低,染色体异常类型也有差异。

Objective To investigate the relationship between histopathological subtype of nonHodgkin＇ s lymphoma（NHL） and chromosomal abnormalities, and compare the difference of chromosomal abnormalities between China and the West. Methods Routine G banding chromosome analysis and fluorescent in situ hybridization（FISH） were performed on lymph node specimens from 155 NHL patients. Results Diffuse large B-cell lymphoma（DLBCL） constituted 38.1% of the cases followed by follicular lymphoma（FL） 17.4%, small lymphocytic lymphoma （SLL） 10.3%, peripheral T-cell lymphoma （PTCL） （ unspecified ） 8.4% , and angioimmunoblastic lymphoma 7.1%. One hundred nineteen patients （76.8%） had clonal chromosomal abnormalities. The incidence of chromosomal abnormalities among FL, SLL, DLBCL, anaplastic large cell lymphoma （ALCL） and precursor T-cell lymphoblastic lymphoma （TLBL） was 96.3%, 87.5%, 86.4%, 83.3% and 83.3%, respectively. Complex karyotype was 86.3% in DLBCL. The most frequent structural abnormalities in DLBCL involved chromosomes 3, 6, 14 and 1, with had high frequencies of 3q27 （41.2%） and 6q21, 6q23, 6q25 involvement （23.5%）. But only 2 cases of DLBCL had classical t（ 14; 18） （q32;q21） which was lower than that in the West （20%）. The positive rate of IgH rearrangement was 40.1% in DLBCL by FISH. No 13q14 deletion was found in 16 cases of SLL. Normal karyotype was observed in 8/11 cases with angioimmunoblastic T-cell lymphoma patients. Conclusions The distribution of the histopathological subtypes of NHL is different among different geographical areas. The chromosomal abnormalities in DLBCL was comparable between China and the West, but t（ 14; 18） was infrequent in the former. The chromosomal abnormalities in SLL was different from the West. The incidence of chromosomal abnormalities in angioimmunoblastic T-cell lymphoma was lower than that in the West.