發(fā)布時間：2018-03-03 09:08

  本文選題：淋巴瘤　切入點：免疫組織化學(xué)　出處：《中華腫瘤防治雜志》2017年06期 　論文類型：期刊論文

【摘要】：目的血管免疫母細胞性T細胞淋巴瘤(angioimmunoblatic T-cell lymphoma,AITL)是一種侵襲性淋巴瘤,本研究探討AITL的臨床病理特征、與EB病毒相關(guān)性及分子遺傳學(xué)改變,并分析相關(guān)預(yù)后因素。方法選取2003-01-03-2012-12-31新疆醫(yī)科大學(xué)第一附屬醫(yī)院有詳細臨床病理資料的16例AITL患者石蠟樣本,EnVision法進行CXCL13、PD-1、CD10和Bcl-6免疫標記;原位雜交技術(shù)檢測腫瘤EB病毒編碼mRNA表達情況;熒光原位雜交技術(shù)檢測腫瘤組織中Bcl-2、Bcl-6和C-MYC基因異常情況,并對所有患者進行隨訪。結(jié)果 16例患者,男11例(68.8%),女5例(31.2%),男女比例2.2∶1。中位年齡65.5歲。75.0%(12/16)患者國際預(yù)后指標(international prognostic indicators,IPI)評分為中高危,56.3%(9/16)患者血清乳酸脫氫酶(lactic dehydrogenase,LDH)異常,20%(2/10)患者存在骨髓侵犯,81.3%(13/16)患者臨床分期為ⅢB期及以上;免疫組織化學(xué)染色結(jié)果示,CXCL13、PD-1、CD10、Bcl-6陽性率分別為93.8%(15/16,95%CI為70%~100%)、75.0%(12/16,95%CI為48%~93%)、50.0%(8/16,95%CI為25%~75%)和81.3%(13/16,95%CI為54%~96%);AITL顯示特征性的CD23和CD21濾泡樹突狀細胞網(wǎng)增生,陽性率均為87.5%(14/16,95%CI為62%~98%);原位雜交:EBER陽性率為56.3%(9/16,95%CI為30%~80%);FISH檢測結(jié)果示,10例AITL患者Bcl-2/IgH、Bcl-6、C-myc檢測均為陰性;術(shù)后電話隨訪,自病理確診之日起開始計算生存期,15例患者有隨訪結(jié)果。隨訪1~84個月,全組中位生存期為17個月;其中5例在1年內(nèi)死亡,1年生存率為66.7%(5/15),總共6例患者死亡,占全組的40.0%(6/15)。單因素分析顯示,年齡≥65歲、IPI評分高危組、LDH水平異常、臨床病理分期ⅢB~Ⅳ期患者預(yù)后較差。結(jié)論 AITL好發(fā)于老年患者,具有高度侵襲性,預(yù)后差,CXCL13、PD-1、CD10、Bcl-6可作為一個免疫組化套餐,在該腫瘤的診斷具有重要作用,臨床病理分期、IPI評分、LDH水平是影響預(yù)后的重要因素。
[Abstract]:Objective angioimmunoblastic T-cell lymphoma (AITL) is an aggressive lymphoma. This study was designed to investigate the clinicopathological features of AITL, its association with Epstein-Barr virus (EBV) and the molecular genetic changes. Methods 16 AITL patients with detailed clinicopathological data were selected from the first affiliated Hospital of Xinjiang Medical University from January 2003 to March 2003.The paraffin envision method was used for CXCL13PD-1 CD10 and Bcl-6 immunolabeling. In situ hybridization technique was used to detect the expression of EBV encoded mRNA, and fluorescence in situ hybridization was used to detect the abnormality of Bcl-2, Bcl-6 and C-MYC genes in tumor tissues, and all the patients were followed up. The international prognostic indicatorsIPI (a median age of 65.5 years .75.0% / 12 / 16) score of international prognostic indicatorsIPI (a median age of 65.5 years .75.0% / 12 / 16) showed that the patients with moderate and high risk (56.3% / 9 / 16) had abnormal serum lactate dehydrogenase dehydrogenase (LDH) abnormality (201.31313 / 16) and the patients had bone marrow invasion (81.31313 / 16). The results of immunohistochemical staining showed that the positive rate of CXCL13PD-1 CD10Bcl-6 was 93.8151516995 CI = 7055.00 / 75.00 / 75.00 / 12 / 169595 / CI, respectively, and the CI was 480.9339.05% and the CI of 81.33% (1316995 CI = 257575) and 81.33% 131616995 CI (51.33%) and 51.33% 131616995 CI (54.93%) and 54.3% 1316995 CI (54.93% / 9695 CI), respectively. The CXCL13PD-1CD10Bcl-6 positive rate was 93.81516995 CI = 705,16995 CI = 705.00% and 75.05%, respectively. The positive rate of in situ hybridization was 56.3% and the positive rate of in situ hybridization was 56.3%. The positive rate of in situ hybridization was 56.3% and the CI was 30%. The results of fish showed that all 10 cases of AITL were negative for Bcl-2% IgHV Bcl-6C-myc, and 15 patients with survival period were followed up from the day of postoperative telephone follow-up. The median survival time of the whole group was 17 months, of which 5 cases died within one year, and the 1-year survival rate was 66.7%. A total of 6 cases died, accounting for 40.0% of the total. Univariate analysis showed that the high risk group of age 鈮，

本文編號：1560393