Hunt Kristin E, Reichard Kaaren K
University of New Mexico, Department of Pathology, Albuquerque, NM 87131, USA.
Arch Pathol Lab Med. 2008 Jan;132(1):118-24. doi: 10.5858/2008-132-118-DLBL.
Diffuse large B-cell lymphoma is the most common lymphoma worldwide. Both morphologically and prognostically it represents a diverse spectrum of disease. Traditional morphologic subclassification often results in poor interobserver reproducibility and has not been particularly helpful in predicting outcome. Recent gene expression profiling studies have classified diffuse large B-cell lymphoma into 2 main subtypes, germinal center B-cell and activated B-cell, with the germinal center type showing an overall better survival. Validation of these subtypes has become possible for the practicing pathologist with the use of surrogate immunohistochemical markers. Importantly however, these prognostic studies were performed on material from the pre-rituximab treatment era. With the now well-accepted addition of rituximab (anti-CD20 antibody) to the typical large B-cell lymphoma chemotherapeutic regimen, a revalidation of any survival differences between the large B-cell lymphoma subgroups is necessary. This short review covers the current clinical, morphologic, immunophenotypic, genetic, gene expression profiling, and prognostic (studies before and after the addition of rituximab) features of de novo diffuse large B-cell lymphoma.
弥漫性大B细胞淋巴瘤是全球最常见的淋巴瘤。在形态学和预后方面，它都代表了一系列不同的疾病。传统的形态学亚分类常常导致观察者间的可重复性较差，并且在预测预后方面并不是特别有用。最近的基因表达谱研究已将弥漫性大B细胞淋巴瘤分为2种主要亚型，即生发中心B细胞型和活化B细胞型，其中生发中心型总体生存率更好。通过使用替代免疫组化标志物，执业病理学家已能够验证这些亚型。然而，重要的是，这些预后研究是在利妥昔单抗治疗前时代的材料上进行的。随着现在已被广泛接受的将利妥昔单抗（抗CD20抗体）添加到典型的大B细胞淋巴瘤化疗方案中，有必要对大B细胞淋巴瘤亚组之间的任何生存差异进行重新验证。这篇简短的综述涵盖了初发性弥漫性大B细胞淋巴瘤目前的临床、形态学、免疫表型、遗传学、基因表达谱以及预后（添加利妥昔单抗前后的研究）特征。
