弥漫性大B细胞淋巴瘤免疫表型分析

Immunophenotypic Analysis of Diffuse Large B-cell Lymphoma

目的:探讨CD10、bcl-6、MUM1和bcl-2蛋白在弥漫性大B细胞淋巴瘤(DLBCL)中的表达及其预后意义。方法:应用免疫组织化学SP法检测59例DLBCL中CD10、bcl-6、MUM1和bcl-2的表达,采用Hans免疫分型方法将DLBCL分为生发中心B细胞(GCB)型和非GCB型,分析免疫表型与预后的关系。结果:在59例DLBCL中,CD10、bcl-6、MUM1和bcl-2蛋白的表达率分别是20.3%(12/59)、37.3%(22/59)、50.8%(30/59)和67.8(40/59)%。Hans分型:28.8%(17/59)为GCB型,71.2%(42/59)为非GCB型。bcl-6表达阳性和GCB亚型患者总生存(OS)率高于bcl-6表达阴性和非GCB亚型患者(P值分别为0.030和0.047),而CD10、MUM1和bcl-2表达对OS率均无明显影响(p值分别为0.057、0.992和0.419)。结论:bcl-6表达和免疫分型与DLBCL患者的预后有关,可成为DLBCL个体化治疗的重要依据。

Abstracts： Objective： To investigate the expression of CD10,bcl-6.MUM1 and bcl-2 protein in diffuse large B-cell lymphoma （DLBCL） and their prognostic significances. Methods： Immunohistochemical SP method was used to detect the expression of CD10, bcl-6, MUM1 and bcl-2 in 59 cases of DLBCL. The Hans algorithm was applied to classify DLBCL into germinal center B-cell （GCB） and non-GCB subtypes. The correlation of prognosis with immunophenotype was analyzed. Result： Of the 59 DLBCL cases, expression of CD10 was ob- served in 12 cases （20.3%）, bcl-6 in 22 （37.3%）, MUM1 in 30 （50.8%）, and bcl-2 in 40 （67.8%）. According to Hans algorithm, 17 cases （28.8%） belonged GCB subtype and 42 cases （71.2%） belonged to non-GCB subtype. The overall survival （OS） rates of bcl-6-positive and GCB subtype patients were higher than that of bcl-6-nega- tive and non-GCB subtype patients（P=0.030 and 0.047, respectively）. The expression of CD10,MUM1 and bcl-2 did not exert significant effect on OS rate （P=0.057, 0.992 and 0.419, respectively）.Conclusion： bcl-6 expression and immunophenotyping are associated with the prognosis of DLBCL patients and might become important bases for tailored therapy of DLBCL.