CAJ | 학술논문

目的探讨c-myc在系统性间变性大细胞淋巴瘤(ALCL)中蛋白表达和基因异常与临床病理特征、免疫组织分型的关系.方法选取ALCL患者87例,应用免疫组织化学EnVision法检测c-mvc、间变性淋巴瘤激酶(ALK)、CD3、CD10、CD20、CD30、EMA的蛋白表达情况;应用荧光原位杂交(FISH)技术检测c-myc和ALK基因异常情况;统计分析c-myc蛋白表达和基因异常与各临床病理参数间的关系.结果免疫组织化学结果:87例ALCL中,ALK阳性者54例(62.1％),c-myc阳性者27例(31.0％),c-myc和ALK蛋白联合表达20例(23.0％).c-myc蛋白表达率、c-myc和ALK蛋白联合表达率随ALCL临床分期的增加而升高,且在国际预后指数(IPI)高危组中表达率高于低危组(P＜0.05).FISH检测结果:87例ALCL中,50例(57.5％)发现ALK基因的易位,19例(21.8％)发现ALK基因的多拷贝.所有患者均未发现c-myc基因的易位,但19例(21.8％)检测到c-myc基因的多拷贝.c-myc基因多拷贝的发生率在ALK蛋白阳性和阴性组中差异无统计学意义(P＞0.05),在c-myc蛋白阳性和阴性组中发生率差异有统计学意义(P＜0.05),在IPI高危组中发生率高于低危组(P＜0.05).结论 c-myc蛋白表达及基因异常与ALCL临床分期、IPI相关,可作为判断ALCL恶性程度和预测预后的指标.
목적 탐토c-myc재계통성간변성대세포림파류(ALCL)중단백표체화기인이상여림상병리특정、면역조직분형적관계.방법 선취ALCL환자87례,응용면역조직화학EnVision법검측c-mvc、간변성림파류격매(ALK)、CD3、CD10、CD20、CD30、EMA적단백표체정황;응용형광원위잡교(FISH)기술검측c-myc화ALK기인이상정황;통계분석c-myc단백표체화기인이상여각림상병리삼수간적관계.결과 면역조직화학결과:87례ALCL중,ALK양성자54례(62.1％),c-myc양성자27례(31.0％),c-myc화ALK단백연합표체20례(23.0％).c-myc단백표체솔、c-myc화ALK단백연합표체솔수ALCL림상분기적증가이승고,차재국제예후지수(IPI)고위조중표체솔고우저위조(P＜0.05).FISH검측결과:87례ALCL중,50례(57.5％)발현ALK기인적역위,19례(21.8％)발현ALK기인적다고패.소유환자균미발현c-myc기인적역위,단19례(21.8％)검측도c-myc기인적다고패.c-myc기인다고패적발생솔재ALK단백양성화음성조중차이무통계학의의(P＞0.05),재c-myc단백양성화음성조중발생솔차이유통계학의의(P＜0.05),재IPI고위조중발생솔고우저위조(P＜0.05).결론 c-myc단백표체급기인이상여ALCL림상분기、IPI상관,가작위판단ALCL악성정도화예측예후적지표.
Objective To investigate the protein expression and genetic alterations of c-myc in primary systemic anaplastic large cell lymphoma (ALCL) and discuss its relationship with clinicopathologic features and immunophenotypes.Methods 87 cases of ALCL were selected.Immunohistochemical method was used to detect the protein expression of c-myc,ALK,CD3,CD10,CD20,CD30 and EMA.c-myc and ALK genetic alterations were detected by using fluorescence in situ hybridization (FlSH).The interrelationships between protein expression,genetic alterations and clinicopathological parameters were analysed statistically.Results Immunohistochemical results:of 87 cases,ALK protein was expressed in 54 cases (62.1％).c-myc protein was expressed in 27 cases (31.0 ％).ALK and c-myc were co-expressed in 20 cases (23.0 ％).c-myc protein expression,ALK and c-myc co-expression increased with the upgrade of ALCL clinical stages,and the expression was higher in International Prognostic Index (IPI) high-risk groups than in low-risk groups (P ＜ 0.05).FISH test results:of 87 ALCL cases,there were 50 cases (57.5 ％) of ALK rearrangements and 19 cases (21.8 ％) of ALK aneuploidy.c-myc rearrangement was detected in none of 87 ALCL cases,but there was aneuploidy in 19 cases (21.8 ％).The differences of c-myc aneuploidy in ALK positive and negative groups were statistically insignificant (P ＞ 0.05),while they were statistically significant in c-myc groups (P ＜ 0.05) and in different IPI groups (P ＜ 0.05).Conclusion c-myc protein expression and aneuploidy were related with ALCL clinical stages and IPI,which could be used as an indicator of estimating ALCL malignant degree and predicting prognosis.