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在MYC和BCL2蛋白表达中的临床病理学差异在初级外节和节点扩散大B细胞淋巴瘤之间

Yohei Sasaki¹, So Murai², Hidenori Hayashi¹

¹Division of Hematology, Department of Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-Ku, Tokyo 142-8666, Japan.

Pathology, research and practice

|July 4, 2024

概括

具有双表达性淋巴瘤 (DEL) 特征的初级外节扩散大B细胞淋巴瘤 (DLBCL) 表明预后不佳. 特别是在额外的DLBCL病例中,DEL是显著的不良预后因素.

科学领域:

血液学血液学血液学
在瘤学瘤学.
免疫组织化学免疫组织化学

背景情况:

扩散型大B细胞淋巴瘤 (DLBCL) 呈现出显著的异质性.
双表达性淋巴瘤 (DEL) 的预后影响,定义为高MYC和BCL2表达,在初级 extranodal与节点DLBCL中仍然不清楚.

研究的目的:

为了研究临床病理学特征,治疗反应和初级节节外和节点DLBCL的临床结果.
为了确定不同DLBCL位置的DEL的预后意义.

主要方法:

在初级 extranodal (n=61) 和节点 (n=128) DLBCL队列之间对临床病理特征的比较分析.
对MYC,BCL2和BCL6表达的免疫组织化学评估.
与预后因素相关的无进展生存 (PFS) 和总生存 (OS) 的评估.

主要成果:

节点DLBCL的BCL2表达高于节点外DLBCL (p=0.048).
高MYC表达和DEL被确定为结节DLBCL的不良预后因素.
在额外的DLBCL中,高BCL2,低BCL6,非生殖中心B细胞类亚型和DEL与预后不佳有关.
在外结节DLBCL (p=0.014和p=0.021) 中,DEL显著影响了PFS和OS,但在结节DLBCL (p=0.37和p=0.084) 中没有影响.

结论:

具有DEL特征的原发性外节DLBCL代表了一个具有不良预后的独特临床实体.
特别是在初级外DLBCL中,DEL是显著的不良预后因素,影响患者的生存结果.

关键词:

扩散大的B细胞淋巴瘤.双表达性淋巴瘤是一种双表达性淋巴瘤.额外的淋巴瘤额外的淋巴瘤结节性淋巴瘤是一种结节性淋巴瘤.

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