首页|原发性CD5+弥漫大B细胞淋巴瘤临床病理及预后的差异分析

原发性CD5+弥漫大B细胞淋巴瘤临床病理及预后的差异分析

扫码查看
目的 探讨CD5+的原发性弥漫大B细胞淋巴瘤(diffuse large B cell lymphoma,DLBCL)的临床病理学特征及其分子突变特征谱.方法 采用免疫组化染色和二代测序技术(NGS)检测,比较原发性CD5+DLBCL和CD5-DLBCL的病理学特征、免疫表型和基因变异谱的差异,分析其与患者临床病理特征及预后的关系.结果 311例DLBCL样本中CD5+DLBCL患者46例(14.7%).CD5+DLBCL与CD5-DLBCL、CD5+DLBCL伴MYD88 L265P变异和不伴MYD88 L265P变异相比,患者性别、临床分期和国际预后指数等差异无统计学意义(P>0.05).免疫表型:CD5+DLBCL组BCL2过表达率(69.5%vs 49.4%,P=0.003)、BCL2和C-MYC双表达率(26%vs 14%,P=0.04)均高于CD5-DLBCL组;CD5+伴MYD88 L265P变异组C-MYC(53%vs 20%)、BCL6(93.3%vs 61.3%)、Ki67(93.3%vs 64.5%)等标记及双表达(46.7%vs 20.8%)均高于CD5+不伴MYD88 L265P变异组患者(P<0.05).生存分析表明,CD5+DLBCL组患者疾病无进展生存时间比CD5-DLBCL组患者更差(P=0.09).此外,CD5+不伴MYD88 L265P变异患者无进展生存时间明显优于CD5+伴MYD88 L265P变异患者(P=0.04).NGS检测发现,CD5+DLBCL和CD5-DLBCL两组患者在伴随突变基因的分布有差异.结论 CD5+标记以及CD5+伴MYD88 L265P变异,可能是DLBCL患者预后不佳的潜在标志物.
Clinical pathology and prognostic differences of primary CD5+diffuse large B cell lymphoma
Purpose To explore the clinicopathological features and molecular characteristics of primary CD5+diffuse large B cell lymphoma(DLBCL).Methods Immunohisto-chemistry and next-generation sequencing(NGS)were used to compare the pathological features,immunophenotypes,and mo-lecular characteristics between primary CD5+DLBCL and CD5-DLBCL,and to analyze their relationship with prognosis and clinical characteristics of patients.Results Among 311 DLBCL patients,there were 46 cases(14.7%)of CD5+DLBCL.There were no statistically significant differences in patient gen-der,clinical staging,international prognostic index between CD5+DLBCL and CD5-DLBCL,and between CD5+DLBCL with and without MYD88 L265P mutation(P>0.05).Immuno-phenotypically,the overexpression of BCL2(69.5%vs 49.4%,P=0.003)and the co-expression of BCL2 and C-MYC(26%vs 14%,P=0.04)were higher in the CD5+DLBCL group than those in the CD5-DLBCL group;the expression of C-MYC(53%vs 20%),BCL6(93.3%vs 61.3%),Ki67(93.3%vs 64.5%),and co-expression(46.7%vs 20.8%)were higher in the CD5+with MYD88 L265P mutation group than those in the CD5+without MYD88 L265P mutation group(P<0.05).Survival analysis showed that the disease progres-sion-free survival time of patients in the CD5+DLBCL group tended to be shorter than that of patients in the CD5-DLBCL group(P=0.09).Furthermore,the disease progression-free survival time of patients in the CD5+without MYD88 L265P mutation group was significantly longer than that of patients in the CD5+with MYD88 L265P mutation group(P=0.04).NGS detection found differences in the distribution of accompan-ying mutated genes between CD5+DLBCL and CD5-DLBCL groups.ConclusionCD5 expression and CD5+with MYD88 L265P mutation may be potential indicators of poor prognosis in DLBCL patients.

primary diffuse large B cell lymphomaimmumo-histochemistyCD5MYD88 L265P

谢嘉玲、施晴、鲍其远、董磊

展开 >

上海交通大学医学院附属瑞金医院病理科,上海 200020

上海交通大学医学院附属瑞金医院血液科,上海 200020

上海交通大学医学院附属瑞金医院骨科,上海 200020

原发性弥漫大B细胞淋巴瘤 免疫组织化学 CD5 MYD88 L265P

2024

临床与实验病理学杂志
安徽医科大学,中华医学会安徽分会

临床与实验病理学杂志

CSTPCD北大核心
影响因子:0.776
ISSN:1001-7399
年,卷(期):2024.40(1)
  • 1