弥漫性大B细胞淋巴瘤中MYC／BCL2蛋白共表达及其意义分析

Expression and significance of MYC/BCL2 protein coexpression in diffuse large B-cell lymphoma

目的：探讨245例弥漫性大B细胞淋巴瘤（DLBCL）中MYC/BCL2蛋白共表达状况及其与生发中心细胞样（GCB）及non-GCB亚型是否存在相关性。方法使用免疫组织化学方法对DLBCL石蜡标本制作的组织芯片进行MYC、BCL2、CD10、BCL6、MUM1、KI67检测，并对蛋白表达状况进行统计分析。结果245例DLBCL标本中，non-GCB患者163例（66．5％），GCB患者82例（33．5％），MYC和BCL2双阳性患者88例，占患者总数的35．9％（88/245），占non-GCB病例的41．7％（68/163），占GCB病例的24．4％（20/82），在这两种亚型表达的差异具有统计学意义（χ2＝7．116，P＝0．008）。结论DLBCL中MYC/BCL2蛋白共表达在non-GCB亚型比GCB亚型更多，可以按照MYC/BCL2的共表达情况，把DLBCL分成不同亚群以区别治疗和判断预后。

Objective To explore the condition of MYC/BCL2 protein coexpression in 245 patients with diffuse large B-cell lymphoma （DLBCL）and to find the correlations among MYC/BCL2 protein coexpres-sion,the germinal center B-cell-like （GCB）subtype and non-GCB subtype.Methods Paraffin-embedded lymphoma samples from 245 patients with DLBCL were studied using immunohistochemistry for MYC,BCL2, CD10,BCL6,MUM1 and KI67.And the protein expressions of them were analyzed.Results In the speci-mens of 245 patients with DLBCL,the patients with non-GCB were 163 （66.5%）,and the patients with GCB were 82 （33.5%）.The group of MYC/BCL2 protein coexpression comprised 35.9% （88/246）of the all patients.Non-GCB subtype group had a significantly higher frequency of MYC/BCL2 protein coexpression than the GCB subtype group （41.7%∶24.4%;χ2 =7.116,P=0.008）.Conclusion The data shows that MYC/BCL2 protein coexpression occurs significantly more commonly in the non-GCB subtype.We can predict prog-nosis and choose therapeutic regimen base on the assessment for MYC and BCL2 protein expression.