白血病·淋巴瘤
白血病·淋巴瘤
백혈병·림파류
JOURNAL OF LEUKEMIA & LYMPHOMA
2011年
3期
140-143
,共4页
段泽君%张永红%时云飞%周春菊%徐教生%薛学敏%李敏%黄欣%张志丽%高子芬
段澤君%張永紅%時雲飛%週春菊%徐教生%薛學敏%李敏%黃訢%張誌麗%高子芬
단택군%장영홍%시운비%주춘국%서교생%설학민%리민%황흔%장지려%고자분
淋巴瘤,大细胞%骨髓%免疫表型分型
淋巴瘤,大細胞%骨髓%免疫錶型分型
림파류,대세포%골수%면역표형분형
Lymphoma,large-cell1%Bone marrow%Immunophenotyping
目的 探讨系统性间变性大细胞淋巴瘤(S-ALCL)骨髓累及的临床病理学特点、免疫学表型及临床生物学行为.方法 回顾性分析34例S-ALCL病例资料,进行骨髓活检(19例)或涂片(15例).其中ALK(+)24例,ALK(-)10例.HE染色、免疫组织化学染色观察病理形态及免疫表型,原位杂交法检测EB病毒.结果 6例(17.6%)S-ALCL存在骨髓累及,均经骨髓活检标本确定,15例患者骨髓涂片中均未见肿瘤累及.ALK(+)ALCL和ALK(-)ALCL骨髓累及的发生率分别为16.7%(4/24)和20.0%(2/10),差异无统计学意义(P=0.3555).与无骨髓累及病例比较,骨髓累及病例的年龄、性别分布差异无统计学意义(P值分别为0.8089和0.3085).骨髓累及者肿瘤细胞以间质性分布为主[83.3%(5/6)].生存分析统计提示伴有骨髓累及的患者预后明显差于无骨髓累及者(P=0.0407).结论 S-ALCL骨髓累及发生率低,与患者的发病年龄、性别及ALK蛋白的表达无相关性.伴有骨髓累及的S-ALCL患者临床预后差,骨髓活检在判断S-ALCL预后中有重要意义.
目的 探討繫統性間變性大細胞淋巴瘤(S-ALCL)骨髓纍及的臨床病理學特點、免疫學錶型及臨床生物學行為.方法 迴顧性分析34例S-ALCL病例資料,進行骨髓活檢(19例)或塗片(15例).其中ALK(+)24例,ALK(-)10例.HE染色、免疫組織化學染色觀察病理形態及免疫錶型,原位雜交法檢測EB病毒.結果 6例(17.6%)S-ALCL存在骨髓纍及,均經骨髓活檢標本確定,15例患者骨髓塗片中均未見腫瘤纍及.ALK(+)ALCL和ALK(-)ALCL骨髓纍及的髮生率分彆為16.7%(4/24)和20.0%(2/10),差異無統計學意義(P=0.3555).與無骨髓纍及病例比較,骨髓纍及病例的年齡、性彆分佈差異無統計學意義(P值分彆為0.8089和0.3085).骨髓纍及者腫瘤細胞以間質性分佈為主[83.3%(5/6)].生存分析統計提示伴有骨髓纍及的患者預後明顯差于無骨髓纍及者(P=0.0407).結論 S-ALCL骨髓纍及髮生率低,與患者的髮病年齡、性彆及ALK蛋白的錶達無相關性.伴有骨髓纍及的S-ALCL患者臨床預後差,骨髓活檢在判斷S-ALCL預後中有重要意義.
목적 탐토계통성간변성대세포림파류(S-ALCL)골수루급적림상병이학특점、면역학표형급림상생물학행위.방법 회고성분석34례S-ALCL병례자료,진행골수활검(19례)혹도편(15례).기중ALK(+)24례,ALK(-)10례.HE염색、면역조직화학염색관찰병리형태급면역표형,원위잡교법검측EB병독.결과 6례(17.6%)S-ALCL존재골수루급,균경골수활검표본학정,15례환자골수도편중균미견종류루급.ALK(+)ALCL화ALK(-)ALCL골수루급적발생솔분별위16.7%(4/24)화20.0%(2/10),차이무통계학의의(P=0.3555).여무골수루급병례비교,골수루급병례적년령、성별분포차이무통계학의의(P치분별위0.8089화0.3085).골수루급자종류세포이간질성분포위주[83.3%(5/6)].생존분석통계제시반유골수루급적환자예후명현차우무골수루급자(P=0.0407).결론 S-ALCL골수루급발생솔저,여환자적발병년령、성별급ALK단백적표체무상관성.반유골수루급적S-ALCL환자림상예후차,골수활검재판단S-ALCL예후중유중요의의.
Objective To investigate the clinicopathological features, immunophenotyping and clinical biological behavior of bone marrow (BM) involvement of systemic anaplastic large-cell lymphoma (S-ALCL).Methods 34 S-ALCL including 24 ALK(+) and 10 ALK(-) cases available with the formalin-fixed, paraffin embedded (FFPE) tissue blocks of BM biopsy (n=19) or BM smear sections (n=15) were included in this study.BM samples were sent to both morphologic evaluation using H&E (Hematoxylin & Eosin)-stained sections and immunophenotypic detection by immunohistochemistry (IHC). EBV status was determined by visualization of EBERs in tumor cells using in situ hybridization (ISH). Results BM involvement was seen in 17.6 % (6/34)S-ALCL patients which were confirmed by BM biopsy. No significant difference in the incidence of BM involvement was observed between ALK(+)[16.7 % (4/24)] and ALK(-) [20.0 % (2/10) S-ALCL (P =0.3555).Age and gender were not associated with the presence or the absence of BM involvement by S-ALCL (P= 0.8089and 0.3085), tumor cells of patients with BM involvement were interstitial distribution. S-ALCL patients with BM involvement have a poor prognosis as compared to those without BM involvement (P =0.0407). Conclusion BM involvement was not frequently seen in S-ALCL. The occurrence of BM involvement by S-ALCL was not associated with age, gender or the expression of ALK protein. BM involvement is an adverse prognostic factor in S-ALCL, BM biopsy is useful to predict the prognosis of S-ALCL.
