【作者】 李合；

【导师】 王晋芬；

【作者基本信息】 山西医科大学 ， 肿瘤学， 2011， 硕士

【摘要】 目的:探讨应用Choi新分类法与Han’s分型后DLBCL的免疫分型与预后的相关性。方法:收集山西省肿瘤医院病理科有详细随访资料的DLBCL99例,用免疫组织化学EnVision法检测bcl-2、bcl-6、CD10、FOXP1、GCET1、Mum-1的表达情况。根据Choi和Han’s两种分类法分别将所有病例分型。其中35例应用荧光原位杂交技术检测bcl-6基因重排情况。结果:按Han’s分类法GCB型共21例(21.9%),nonGCB78例(78.1%)。Choi的新分类法则将Han’s分类法中的4例进行了重新分类,GCB型共23例(23.2%),nonGCB型76例(76.8%),根据随访资料确认重新分类的病例与估计预后一致。分类后的GCB组生存率明显优于nonGCB组(P=0.000)有统计学意义。FOXP1阳性组与阴性组的预后有意义(P=0.011)。GCET1阳性组与阴性组的预后差异也有统计学意义(P=0.027)。bcl-2蛋白的表达对预后无影响,但对Han’s及Choi分型有意义(P值分别为0.003和0.000)。35例DLBCL患者中3q27染色体断裂7例(20%),扩增10例(28.6%)。Bcl-6基因易位重排病例(共为15例,43%)高发于nonGCB型中,bcl-6基因重排与bcl-6蛋白的表达没有明显相关性。结论:两种分类法免疫分型GCB组预后都优于nonGCB组。bcl-6、FOXP1、GCET1的表达与预后有相关性。bcl-2蛋白的表达对两种分型有意义。Choi及Han’s分类法对DLBCL的免疫分型、临床预后估计均有应用价值。更多还原

【Abstract】 Purpose To detect the correlation of DLBCL to the prognosis using Choi’s and Han’s classification.Methods Ninty-nine cases of DLBCL were studied using immunohistochemistry EnVision method for bcl-2,bcl-6,CD10, FOXP1 ,GCET1,MUM1 in Shanxi Tumor Hospital. Follow-up was included. They were classified according to Han’s and Choi algorithm. Fluorescence in situ Hybridization (FISH) for bcl-6 gene expression(located on chromosome 3q27)was performed on paraffin-embedded tissues of 35 case.Results In Han’s classification, 21(21.9%) cases were GCB subtype and 78 cases(78.1%) nonGCB subtype. The Choi’s classification has been re-classified 4 cases, 23(23.2%) cases were GCB subtype and 76 cases(76.8%) nonGCB subtype, the follow-up data also confirmed that this new classification was included in the 4 patients with similar prognosis classified group. GCB group survival rate was better than nonGCB’s (P = 0.000) by Choi’s. The prognosis of FOXP1-positive group was better than negative group (P = 0.011). There were significant differences in prognosis between GCET1 positive group and negative group (P = 0.027).Bcl-2 protein expression was useful for Hans(P=0.003) and Choi’s(P=0.000) classification but not benefit for prognosis. Breakage of 3q27 was detected in 7 of the 35 case(20%)and proliferation was detected in 10 case(28%).Bcl-6 rearrangement was more frequently encountered in the nonGCB-like type(15 was positive in all 35 cases,43%).There is no relationship between bcl-6 gene rearrangement and bcl-6 protein expression.Conclusion On the basis of classification , GCB group had a better clinical outcome than nonGCB group. FOXP1, GCET1 ,bcl-6protein expression is associated with different outcome in DLBCL. bcl-2 protein expression is helpful for immunophenotyping. Both of Choi and Han’s algorithm were play an important role in immunophenotyping and prognosis.更多还原