论文部分内容阅读
目的探讨EB病毒诱发人弥漫大B细胞淋巴瘤(DLBCL)的分子病理特性。方法 50例EB病毒诱发人DLBCL患者,应用EBV原位杂交技术、免疫组化及实时荧光定量PCR法,并对分子病理特性展开探讨。结果 50例EB阳性DLBCL病例中病变仅累及淋巴结11例,仅位于淋巴结外器官19例,既有淋巴结病变又伴结外累及20例。中位生存35个月。分析组织学特征:可见多形性淋巴样细胞散在或弥漫浸润性分布,背景部分情况下可见嗜酸细胞。本组多形性亚型15例,大细胞亚型34例,混合亚型1例。免疫表型:40例老年EB阳性DLBCL组中bcl-6表达为15%,较非老年组40%低,但差异无统计学意义(P>0.05)。老年EB阳性DLBCL组中血EBV病毒DNA检出率为50%,明显高于非老年组检出率10%,差异有统计学意义(P<0.05)。结论老年EB阳性DLBCL属临床病理特征独特的DLBCL亚型,但与非老年EB阳性DLBCL有一定相似性,需结合免疫学、临床等资料,与其他类型淋巴瘤鉴别。
Objective To investigate the molecular pathology of Epstein-Barr virus-induced diffuse large B cell lymphoma (DLBCL). Methods Fifty cases of Epstein-Barr virus (EBV) -induced human DLBCL were studied by EBV in situ hybridization, immunohistochemistry and real-time fluorescence quantitative PCR. Results Of the 50 cases with EB-positive DLBCL, the lesions only involved lymph nodes in 11 cases, only 19 cases were located in the lymph nodes. There were both lymph node lesions and extra-nodal involvement in 20 cases. The median survival of 35 months. Analysis of histological features: visible polymorphic lymphoid cells scattered or diffuse infiltration distribution, background eosinophils can be seen in some cases. The group of pleomorphic subtype in 15 cases, 34 cases of large cell subtype, mixed subtype in 1 case. Immunophenotype: The expression of bcl-6 in 15 elderly EB-positive DLBCL patients was 15%, which was lower than that in non-elderly patients (40%), but the difference was not statistically significant (P> 0.05). The detection rate of EBV DNA in elderly EB-positive DLBCL group was 50%, which was significantly higher than that in non-elderly group (10%) (P <0.05). Conclusion Elder EB-positive DLBCL is a DLBCL subtype with unique clinicopathological features, but it has some similarities with non-elderly EB-positive DLBCL. It needs to be distinguished from other types of lymphoma by immunological and clinical data.