Division of Molecular Histopathology, Department of Pathology, University of Cambridge, UK.
J Pathol. 2010 Mar;220(4):461-74. doi: 10.1002/path.2665.
The diagnosis of splenic marginal zone lymphoma (SMZL) is frequently a challenge, due to its lack of specific histological features and immunophenotypic markers, and the existence of other poorly characterized splenic lymphomas defying classification. Moreover, the clinical outcome of SMZL is variable, with 30% of cases pursuing an aggressive clinical course, the prediction of which remains problematic. Thus, there is a real need for biomarkers in the diagnosis and prognostication of SMZL. To search for genetic markers, we comprehensively investigated the genomic profile, TP53 abnormalities, and immunoglobulin heavy gene (IGH) mutation in a large cohort of SMZLs. 1 Mb resolution array comparative genomic hybridization (aCGH) on 25 SMZLs identified 7q32 deletion (44%) as the most frequent copy number change, followed by gains of 3q (32%), 8q (20%), 9q34 (20%), 12q23-24 (8%), and chromosome 18 (12%), and losses of 6q (16%), 8p (12%), and 17p (8%). High-resolution chromosome 7 tile-path aCGH on 17 SMZLs with 7q32 deletion identified by 1 Mb aCGH or interphase FISH screening mapped the minimal common deletion to a 3 Mb region at 7q32.1-32.2. Although it is not yet possible to identify the genes targeted by the deletion, interphase FISH screening showed that the deletion was seen in SMZL (19/56 = 34%) and splenic B-cell lymphoma/leukaemia unclassifiable (3/9 = 33%), but not in 39 cases of other splenic lymphomas including chronic lymphocytic leukaemia (n = 14), hairy cell leukaemia (4), mantle cell lymphoma (12), follicular lymphoma (6), and others. In SMZL, 7q32 deletion was inversely correlated with trisomy 18, but not associated with other copy number changes, TP53 abnormalities, or IGH mutation status. None of the genetic parameters examined showed significant and independent association with overall or event-free survival. In conclusion, 7q32 deletion is a characteristic feature of SMZL, albeit seen in isolated cases of splenic B-cell lymphoma/leukaemia unclassifiable, and its detection may help the differential diagnosis of splenic B-cell lymphomas.
脾边缘区淋巴瘤(SMZL)的诊断常常具有挑战性,这是由于其缺乏特异性组织学特征和免疫表型标志物,并且存在其他难以分类的脾淋巴瘤。此外,SMZL 的临床结果是可变的,其中 30%的病例呈现侵袭性临床病程,这一预测仍然存在问题。因此,SMZL 的诊断和预后需要生物标志物。为了寻找遗传标志物,我们全面研究了一组大型 SMZL 中的基因组谱、TP53 异常和免疫球蛋白重链基因(IGH)突变。对 25 例 SMZL 进行 1 Mb 分辨率的阵列比较基因组杂交(aCGH)鉴定出 7q32 缺失(44%)为最常见的拷贝数变化,其次是 3q 增益(32%)、8q 增益(20%)、9q34 增益(20%)、12q23-24 增益(8%)和 18 号染色体增益(12%),以及 6q 缺失(16%)、8p 缺失(12%)和 17p 缺失(8%)。对通过 1 Mb aCGH 或间期 FISH 筛选鉴定出的 17 例具有 7q32 缺失的 SMZL 进行高分辨率染色体 7 平铺路径 aCGH,将最小共同缺失定位在 7q32.1-32.2 的 3 Mb 区域。尽管目前尚无法确定缺失所针对的基因,但间期 FISH 筛选显示,该缺失可见于 SMZL(56 例中有 19 例[34%])和脾 B 细胞淋巴瘤/白血病不能分类(9 例中有 3 例[33%]),但在其他 39 例脾淋巴瘤中未见缺失,包括慢性淋巴细胞白血病(n=14)、毛细胞白血病(4 例)、套细胞淋巴瘤(12 例)、滤泡性淋巴瘤(6 例)和其他。在 SMZL 中,7q32 缺失与三体 18 呈负相关,但与其他拷贝数变化、TP53 异常或 IGH 突变状态无关。检查的遗传参数均与总生存或无事件生存无显著独立相关性。总之,7q32 缺失是 SMZL 的特征性特征,尽管在孤立的脾 B 细胞淋巴瘤/白血病不能分类病例中也可见到,其检测有助于脾 B 细胞淋巴瘤的鉴别诊断。