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目的 :探讨滤泡性淋巴瘤(FL)的免疫表型和遗传学改变。方法:连续性收集54例FL患者及27例弥漫性大B细胞淋巴瘤(DLBCL)合并FL(DLBCL+FL),用免疫组织化学检测B细胞淋巴瘤(Bcl)2基因、CD10、Bcl-6、多发性骨髓瘤原癌基因1(MUM1)和Ki67的表达情况,并采用荧光原位杂交(FISH)技术检测t(14;18)、Bcl-6和Myc基因重排情况。结果:FL1~2级23例,FL3级31例。FL的t(14;18)阳性率为53.7%,其中FL1~2级组阳性率为100%,而FL3级组阳性率为19.4%,明显低于FL1~2级(P=0.000 1)。FL的Bcl-6基因重排阳性率为14.8%,全部分布于FL3级,FL1~2级未见有Bcl-6基因重排。DLBCL+FL组的Bcl-6基因重排阳性率为37.5%,未见有t(14;18)。FL1~2级组的Bcl-2、CD10和Bcl-6均为阳性,MUM1多为阴性,44.5%的病例Ki67低表达。而FL3级组及DLBCL+FL组中CD10阳性率明显降低,Ki67均为高表达,大部分MUM1表达阳性。结论:FL1~2级组的t(14;18)阳性率高,免疫表型经典。FL3级组的t(14;18)阳性率则显著降低,而Bcl-6基因重排阳性率明显增高,CD10表达率明显降低。
Objective: To investigate the immunophenotypic and genetic changes of follicular lymphoma (FL). Methods: Fifty-four patients with FL and 27 patients with DLBCL combined with FL (DLBCL + FL) were collected continuously. The expressions of Bcl-2, CD10 and Bcl-6 were detected by immunohistochemistry , Multiple myeloma proto-oncogene 1 (MUM1) and Ki67. Fluorescence in situ hybridization (FISH) was used to detect the gene rearrangements of t (14; 18), Bcl-6 and Myc. Results: FL1 ~ 2 grade 23 cases, FL3 grade 31 cases. The positive rate of t (14; 18) in FL was 53.7%. The positive rate of FL1 ~ 2 was 100%, while that of FL3 was 19.4%, which was significantly lower than that of FL1 ~ 2 (P = 0.000 1). FL positive rate of Bcl-6 gene rearrangement was 14.8%, all distributed in FL3 level, FL1 ~ 2 no Bcl-6 gene rearrangement. The positive rate of Bcl-6 gene rearrangement in DLBCL + FL group was 37.5%, no t (14; 18) was found. FL1 ~ 2 group Bcl-2, CD10 and Bcl-6 were positive, MUM1 mostly negative, 44.5% of cases Ki67 low expression. However, the positive rates of CD10 in FL3 group and DLBCL + FL group were significantly lower than those in DLBCL + FL group. Ki67 was highly expressed and most of MUM1 was positive. Conclusion: The positive rate of t (14; 18) in FL1 ~ 2 group is high and the immunophenotype is classic. The positive rate of t (14; 18) in FL3 group was significantly decreased, while the positive rate of Bcl-6 gene rearrangement was significantly increased, and the expression of CD10 was significantly decreased.