原发性中枢神经系统淋巴瘤的分子亚型与临床病理研究

Study of the molecule subtype of primary central nervous system lymphoma with their clinical pathology

目的探讨原发性中枢神经系统淋巴瘤(PCNSL)的分子亚型及与临床病理的关系。方法采用EnVision免疫组化法标记59例PCNSL中MUM1、Bcl-6、CD10、Bcl-2、Ki-67的表达。结果 59例PCNSL中,11例为生发中心细胞样型(GCB),48例为非生发中心细胞样型(no-GCB)。No-GCB型的增殖活性与GCB型相似;BCL-2阳性率为72.9%(43/59),ki67增殖指数平均为82.4%;BCL-2阴性率27.1%(16/59),ki67增殖指数平均为63.0%,两组在统计学分析有意义(P<0.05)。结论 PCNSL的分子分型以no-GCB型多见,GCB组与No-GCB组两组的恶性程度无明显差异。PCNSL多起自GC,且大多数起源于"活化GC",即GC晚期的B细胞;BCL-2阳性表达与肿瘤的恶性程度呈正相关,预示着患者的预后可能更差。

Objective To explore the correlation of the molecule subtype of primary central nervous system lymphoma with clinical pathology.Methods Immunohistochemical stain for MUM1,BCL-6,CD10,BCL-2,Ki-67 were performed in 59 cases of primary central nervous system lymphoma.Results Of 59 primary central nervous system lymphoma,11cases were classified as germinal center B-cell-like group（GCB）,and 48cases as non-germinal center B-cell-like group（non-GCB）.The proliferative activity of GCB was similar to non-GCB.BCL-2 was expressed in 72.88%（43/59）,BCL-2 was not expressed in 27.12%（16/59）.Conclusion The non-GCB is predominant in primary central nervous system lymphoma,and has a similar prognosis with GCB.The main argument supporting the ＂late GC＂ origin is the presence of ongoing mutational activity in most PCNSLs.The proliferative activity of BCL-2＋ was higher than BCL-2-.