Choi和Hans分型在弥漫大B细胞淋巴瘤预后评价中的意义

Significance of Choi′s and Hans′s classification of DLBCL in the clinical prognosis

目的探讨Choi和Hans分型在弥漫大B细胞淋巴瘤（DLBCL）预后评价中的意义。方法收集山西省肿瘤医院病理科有详细随访资料的DLBCL99例，用免疫组织化学EnVision法检测bcl-2、bel-6、CD10、FOXPl、GCETl、MUM-1的表达情况。根据Choi和Hans两种分类法分别将所有病例分型。其中35例应用荧光原位杂交技术检测bcl-6基因重排情况。结果按Hans分类法生发中心B细胞（GCB）型21例，非GCB（nonGCB）型78例；按Choi分类法GCB型23例，nonGCB型76例。GCB型生存率明显优于nonGCB型，差异有统计学意义（P=0．000）。FOXPl蛋白阳性表达与预后呈负相关（P=0．011），GCETl阳性表达则与预后呈正相关（P=0．027）。在35例DLBCL患者中，bcl-6基因重排阳性高发于nonGCB型患者，bcl-6基因重排与bcl-6蛋白的表达没有明显相关性。结论Choi和Hans两种分类法免疫分型GCB型预后都优于nonGCB型。bcl-6、FOXPl、GCETl的表达与预后有相关性。Choi及Hans分类法对DLBCL的免疫分型、临床预后估计均有应用价值。

Objective To detect the correlation of immunophenotyping of DLBCL with Choi＇s and Han＇s classification to the prognos is. Methods Ninty-nine cases of DLBCL were studied using immunohistochemistry EnVision method for bcl-6, CD10, FOXP1, GCET1, MUM1 in Shanxi cancer hospital. The follow-up was included. All cases they were classified according to Hans ＂s and Choi ＂s algorithm. Fluorescence in situ hybridization （FISH） for bcl-6 gene expression （located on chromosome 3q27） was performed on paraffin-embedded tissues of 35 cases. Results In Hans classification, 21 cases were GCB and 78 were nonGCB subtype. In Choi＇s classification, 23 cases were GCB and 16 cases were nonGCB subtype. According to the both classification, the prognosis in GCB group was much better than that in nonGCB＂ s （P -- 0.000）. The expression of FOXP1 was inverse proportion to the prognosis （P =0.011）, on the contrary GCET1 expression was in proportion to the prognosis （P =0.027）. Among all of 35 DLBCL cases, bcl-6 rearrangement was more frequently encountered in the nonGCB type. bcl-6 gene rearrangement was no correlated to bcl-6 protein expression. Conclusion On the basis of classification, GCB group had a better clinical outcome than that of nonGCB group. FOXP1, GCET1, bcl-6 protein expression is associated with different outcome in DLBCL. Both of Choi＇s and Hans＇s algorithm play an important role in the immunophenotyping and prognosis.