CAJ | 학술논문

目的：探讨弥漫大B细胞淋巴瘤（DLBCL）中预后蛋白的表达及bcl-6基因重排情况。方法应用免疫组化SP法，检测CD5、CD10、bcl-6、MUM1和bcl-2蛋白在29例DLBCL中的表达。根据CD10、bcl-6和MUM1的表达情况将DLBCL分为生发中心B细胞型（GCB型）和非生发中心B细胞型（non-GCB型）。应用荧光原位杂交（FISH）技术检测bcl-6基因重排。结果29例DLBCL中年龄＜18岁者11例，CD5、CD10、bcl-6、MUM1和bcl-2阳性表达率分别为18．2％（2/11）、45．5％（5/11）、54．5％（6/11）、36．4％（4/11）和63．6％（7/11），GCB 型6例（54．5％）、non-GCB 型5例（45．5％），bcl-6基因断裂1例（10．00％）、扩增2例（20．00％）；≥18岁者18例，CD5、CD10、bcl-6、MUM1和bcl-2阳性表达率分别为16．7％（3/18）、0（0/18）、44．4％（8/18）、83．3％（15/18）和55．6％（10/18）；GCB型1例（5．6％）、non-GCB型17例（94．4％），bcl-6基因断裂5例（27．8％）。 bcl-6和bcl-2蛋白表达儿童DLBCL与成人DLBCL比较差异无统计学意义（P＝0．710、0．717）。 bcl-2蛋白表达儿童GCB型和non-GCB型DLBCL比较差异无统计学意义（P＝1．000）。结论成人DLBCL以non-GCB型为主，bcl-6基因重排常见。儿童DLBCL以GCB型多见，bcl-2蛋白不是DLBCL的预后指标。
목적：탐토미만대B세포림파류（DLBCL）중예후단백적표체급bcl-6기인중배정황。방법응용면역조화SP법，검측CD5、CD10、bcl-6、MUM1화bcl-2단백재29례DLBCL중적표체。근거CD10、bcl-6화MUM1적표체정황장DLBCL분위생발중심B세포형（GCB형）화비생발중심B세포형（non-GCB형）。응용형광원위잡교（FISH）기술검측bcl-6기인중배。결과29례DLBCL중년령＜18세자11례，CD5、CD10、bcl-6、MUM1화bcl-2양성표체솔분별위18．2％（2/11）、45．5％（5/11）、54．5％（6/11）、36．4％（4/11）화63．6％（7/11），GCB 형6례（54．5％）、non-GCB 형5례（45．5％），bcl-6기인단렬1례（10．00％）、확증2례（20．00％）；≥18세자18례，CD5、CD10、bcl-6、MUM1화bcl-2양성표체솔분별위16．7％（3/18）、0（0/18）、44．4％（8/18）、83．3％（15/18）화55．6％（10/18）；GCB형1례（5．6％）、non-GCB형17례（94．4％），bcl-6기인단렬5례（27．8％）。 bcl-6화bcl-2단백표체인동DLBCL여성인DLBCL비교차이무통계학의의（P＝0．710、0．717）。 bcl-2단백표체인동GCB형화non-GCB형DLBCL비교차이무통계학의의（P＝1．000）。결론성인DLBCL이non-GCB형위주，bcl-6기인중배상견。인동DLBCL이GCB형다견，bcl-2단백불시DLBCL적예후지표。
Objective To investigate the expression of prognostic protein and rearrangement of bcl -6 gene in diffuse large B-cell lymphoma (DLBCL).Methods Expression of CD5,CD10,bcl-6,MUM-1 and bcl-2 in 29 cases of DLBCL was de-tected by immunohistochemistry SP method .The patients were divided into germinal center B-cell( GCB) type and non-GCB type according to the expression of CD10,bcl-6 and MUM-1.Fluorescence in situ hybridization(FISH)was employed to detect the rear-rangement of bcl-6 gene.Results 11 patients were under 18 among the 29 patients,in which the positive expression rates of CD5,CD10,Bcl-6,MUM-1 and Bcl-2 were 18.2%(2/11),45.5%(5/11),54.5%(6/11),36.4%(4/11) and 63.7%(7/11),respectively,and there had 6 cases (54.5%)of GCB type and 5 cases(45.5%)of non-GCB type,bcl-6 gene breakage were founded in 1 cases(10.0%)and bcl-6 gene amplification were detected in 2 cases(20.0%).18 patients were 18 years old or o-ver 18,the positive expression rates of CD5、CD10、bcl-6、MUM-1 and bcl-2 were 16.7%(3/18),0(0/18),44.4%(8/18),83. 3%(15/18)and 55.6%(10/18),respectively;there had 1 case (5.6%)of GCB type and 17 cases (94.4%)of non-GCB type, bcl-6 gene breakage were detected in 5 cases(27.8%).There were no significant difference for bcl-2 an bcl-6 protein expression between children and adult DLBCL patients (P=0.710,0.717).There were no significant difference for bcl-2 protein expression between children GCB type and none-GCB type.Conclusion Non-GCB is the main type in adult DLBCL patients ,and bcl-6 gene rearrangement is common .GCB type is more common in children DLBCL patients ,and the positive expression of bcl-2 pro-tein is not associated with prognosis of DLBCL .