滤泡性淋巴瘤3B级的BCL2融合基因、BCL6分离基因及相应蛋白的表达

Preliminary Study of BCL2 Fusion Gene, BCL6 Gene and Corresponding Protein Expression in Follicular Lymphoma Grade 3B

目的研究滤泡性淋巴瘤(follicular lymphoma,FL)3B级的形态学及细胞遗传学特征,探讨其与滤泡性淋巴瘤1-3A级和弥漫大B细胞淋巴瘤在疾病谱系上的关系。方法用荧光原位杂交技术(FISH)和免疫组织化学检测35例FL和9例生发中心B细胞(GCB)亚型弥漫大B细胞淋巴瘤中的BCL2/IGH融合基因、BCL6分离基因以及BCL2蛋白、BCL6蛋白的表达。采用SPSS13.0软件对数据进行统计分析,率的比较用卡方检验和Fisher精确检验概率法,计量资料用方差分析,P<0.05认为差异有统计学意义。相关性分析用Spearman秩相关检验。结果 FL3B级中BCL2/IGH融合发生率(27%)低于FL1-3A级(86%),差别有统计学意义(P<0.002)。该级别中BCL2蛋白表达率(45%)低于FL1-3A级(96%),差别有统计学意义(P<0.005),而与GCB的BCL2蛋白表达(22%)差别无统计学意义。各组中BCL2蛋白表达与BCL2/IGH融合、BCL6蛋白与BCL6基因分离未见相关性。结论 FL3B在形态上介于FL3A与GCB DLBCL之间,在细胞遗传学改变上更为接近GCB DLBCL,而较低的BCL2/IGH融合率提示其可能存在着一种不同于FL1-3A和GCB DLBCL的发病途径。

Objective To study the morphological and cytogenetic characteristics of the follicular lymphoma（FL） grade 3B and the association of disease pedigree between the follicular lymphoma grade 1-3A and the diffuse large B-cell lymphoma（DLBCL）. Methods Thirty-five FL and 9 GCB-DLBCL were detected by fluorescence in situ hybridization（FISH） and immunohistochemistry. The BCL2/IGH fusion and the BCL6 separation were researched respectively by FISH. BCL2 and BCL6 proteins were detected by immunohistochemistry. All their statistical comparisons were conducted by SPSS13.0 Software. Results The prevalence of BCL2 fusion was lower in FL3B compared with FL1-3A（27% vs. 86%, P〈0.05） . BCL2 protein expression rate was less in FL3B than that in FL1-3A （45% vs. 96%, P〈0.05）. There was no correlation between BCL2 protein expression and BCL2/IGH fusion, as well as BCL6 separation in each group. Conclusion The follicular lymphoma grade 3B had an intermediate morphological form between the follicular lymphoma 3A and the diffuse large B-cell lymphomas .The cytogenetic change of FL3B was closed to diffuse large B-cell lymphomas. The lower BCL2/IGH fusion rate of FL3B suggested that FL3B had a different carcinogenic, pathway from FL1-3A and the diffuse large B-cell lymphomas.