淋巴组织增生性病变中βⅢ-微管蛋白的表达及意义

Expression ofβⅢ-tubulin in lymphoproliferative lesions and its clinicopathological significance

目的探讨βⅢ-微管蛋白(βⅢ-tubulin,TUBB3)在反应性增生淋巴结和淋巴瘤中的表达,分析TUBB3在淋巴瘤诊断与鉴别诊断中的价值。方法采用免疫组化EnVision法检测20例反应性增生淋巴结和126例非霍奇金淋巴瘤(包括88例B细胞性淋巴瘤和38例T细胞性和NK细胞性淋巴瘤)中TUBB3的表达,并复习相关文献。结果反应性增生淋巴结中,TUBB3高度局限于淋巴滤泡生发中心内。小淋巴细胞性淋巴瘤(small lymphocytic lymphoma,SLL)和结外黏膜相关性淋巴组织边缘区淋巴瘤(extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue,MALToma)中,除了残留的淋巴滤泡表达TUBB3外,肿瘤细胞均不表达TUBB3。5例套细胞淋巴瘤(mantle cell lymphoma,MCL)中,1例表达TUBB3。24例低级别滤泡性淋巴瘤(follicular lymphoma,FL)中,8例表达TUBB3。39例弥漫大B细胞淋巴瘤(diffuse large B-cell lymphoma,DLBCL)中,15例表达TUBB3,TUBB3在生发中心样(germinal center B-like,GCB)型中的表达高于非生发中心样(non-germinal central B-like,non-GCB)型,但差异无统计学意义(P>0.05)。15例外周T细胞性淋巴瘤(非特指型)中,TUBB3阳性3例;15例NK/T细胞性淋巴瘤、3例间变性大细胞性淋巴瘤(anaplastic large cell lymphoma,ALCL)和5例血管免疫母细胞性T细胞性淋巴瘤(angioimmunoblastic T-cell lymphoma,AITL)均不表达TUBB3。TUBB3在DLBCL中的阳性率高于成熟性小B细胞性淋巴瘤(P<0.05)。TUBB3在B细胞性淋巴瘤中的阳性率明显高于其在NK细胞/T细胞性淋巴瘤中的阳性率(P<0.05)。结论TUBB3高度局限于反应性增生淋巴结的淋巴滤泡生发中心内,有助于低级别FL、SLL和MALToma的鉴别诊断。

Purpose To analyze the expression ofβⅢ-tubulin(TUBB3)in reactive hyperplastic lymph nodes and lymphomas,and to explore the value of TUBB3 in the diagnosis and differential diagnosis of lymphoma.Methods Immunohistochemical EnVision method was used to detect the expression of TUBB3 in 20 cases of reactive hyperplastic lymph nodes and 126 cases of non-Hodgkin’s lymphoma,including 88 cases of B-cell lymphoma and 38 cases of T-cell and NK-cell lymphoma.The relevant literatures were also reviewed.Results In all reactive hyperplastic lymph nodes,TUBB3 was highly confined to the germinal center of lymphoid follicles.In small lymphocytic lymphoma(SLL)and extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue(MALToma),except for TUBB3 expression in residual lymphoid follicles,all tumor cells did not express TUBB3.Of 5 cases of mantle cell lymphoma(MCL),1 case expressed TUBB3.In 24 cases of low-grade follicular lymphoma(FL),8 cases were positive for TUBB3.Among 39 cases of diffuse large B cell lymphoma(DLBCL),the expression of TUBB3 was observed in 15 cases.TUBB3 in germinal center B-like(GCB)type was higher than that in non-germinal center B like(non-GCB)type,but there was no significant difference(P>0.05).In 15 cases of peripheral T cell lymphoma,NOS,3 cases were positive for TUBB3,and TUBB3 was not expressed in all 15 cases of NK/T cell lymphoma,3 cases of anaplastic large cell lymphoma(ALCL)and 5 cases of angioimmunoblastic T-cell lymphoma(AITL).The positive expression rate of TUBB3 in DLBCL was higher than that in mature small B-cell lymphoma(P<0.05).The positive expression rate of TUBB3 in B-cell lymphoma was significantly higher than that in NK cell/T-cell lymphoma(P<0.05).Conclusion TUBB3 is highly confined to the lymphatic follicular germinal center of reactive hyperplastic lymph nodes,which can be helpful for the differential diagnosis of low-grade FL,SLL and MALToma.