Bcl2表达对不同细胞来源弥漫大B细胞淋巴瘤临床病理特征及预后.doc

Bcl2表达对不同细胞来源弥漫大B细胞淋巴瘤临床病理特征及预后 　 作者：裴媛媛，杨文秀，王松，薄丽，孟青 【摘要】 目的： 了解Bcl2表达对不同基因表达谱细胞来源的弥漫大B细胞淋巴瘤（DLBCL）临床病理特征和预后的影响。方法： 收集42例弥漫大B细胞淋巴瘤组织，常规HE及免疫组织化学染色，观察DLBCL的组织形态特点、肿瘤细胞的免疫表型和Bcl2的表达；搜集临床病理资料和随访，并进行统计学分析。结果： 42例DLBCL中31例表达Bcl2（73.8%），生发中心细胞来源样（14/17）和活化后细胞来源样（17/25）DLBCL病例之间Bcl2表达没有统计学差异，但Bcl2阳性和阴性病例之间临床分期有明显差别，Bcl2阳性病例临床分期明显晚于阴性病例(Plt;0.05)；原发于结外的DLBCL淋巴结累及者多为Bcl2阳性病例（5/6），Bcl2阳性DLBCL病例的生存状况有差于阴性病例的趋势（P=0.06）。结论： DLBCL中Bcl2表达与肿瘤细胞的基因表达谱没有明显关系，但与DLBCL的临床病理过程和预后有关，可能是判断DLBCL预后的相关因子。 【关键词】 淋巴瘤； Bcl2； 病理学； 预后 　　［Abstract］ Objective: To investigate the influence of Bcl2 expression on clinicopathological features and prognosis of diffuse large B cell lymphoma (DLBCL) developed from different cell origins. Methods: Tissues of 42 cases of DLBCL were screened from 180 cases of B cell nonHodgkin lymphoma. Sections were stained with routine HE method, and immunophenotypes of neoplastic cell, such as CD20, CD3, CD10, Bcl6, Bcl2 and MUM1, were examined with immunohistochemistry (IHC) stained sections. The clinical and pathological data of all cases were collected. Some patients were followed up. Statistical analysis was done. Results: The expression of Bcl2 was found in 31 out of 42 case of DLBCL (73.8%). There was no statistically significant difference of Bcl2 expression between GBClike (14/17) and ABClike (17/25) DLBCL. The relation of Bcl2 expression with age, sex, site of DLBCL was not found, but it was associated with clinical staging of the disease. The stages of Bcl2positive DLBCL cases were later than those of Bcl2negative DLBCL cases (Plt;0.05). Most of the DLBCL cases that originated outside nodes showed positive expression of Bcl2 (5/6). There was a tendency that the survival status of Bcl2positive cases was worse than that of Bcl2negative cases (P=0.06). Conclusions: The expression of Bcl2 in DLBCL doesn’t associate with the gene expression spectra obviously, but it affects the clinical course and prognosis of DLBCL. Bcl2 may be one of predictive factors for