Department of Pathology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan, ROC.
Mod Pathol. 2010 Nov;23(11):1507-17. doi: 10.1038/modpathol.2010.139. Epub 2010 Aug 27.
Extranodal marginal-zone lymphoma of mucosa-associated lymphoid tissue of the stomach (gastric MALT lymphoma) is derived from memory B cells of the marginal zone. Normal memory B cells do not express markers of germinal-center B cells, such as E2A (immunoglobulin enhancer-binding factor E12/E47), B-cell chronic lymphocytic leukemia/lymphoma 6 (BCL6), or activation-induced cytidine deaminase (AID). E2A is a transcription factor that induces somatic hypermutations and blocks plasma cell differentiation. In 50 stage-I(E)/II(E1) gastric MALT lymphomas, we confirmed that all cases were BCL6(-)/AID(-), but a subset (50%, 25/50) was E2A(+). As E2A(-) and E2A(+) gastric MALT lymphomas had similar numbers of somatic hypermutations without intraclonal variations, which implied an origin from memory B cells, the expression of E2A was best regarded as a marker of aberrant follicular differentiation. Although the status of somatic hypermutation was not affected by E2A, E2A(+) gastric MALT lymphoma showed less plasmacytoid infiltrates and higher expressions of miRNA-223, a microRNA associated with memory B cells. Clinically, E2A(+) gastric MALT lymphomas were more likely to spread to perigastric lymph nodes and were less responsive to Helicobacter eradication therapy than were E2A(-) gastric MALT lymphomas. Taken together, aberrant E2A expression is a diagnostic feature of a subtype of gastric MALT lymphoma with weaker plasmacytoid infiltrates and stronger miR-223 expression. A prospective study would be necessary to verify the association between E2A expression and a poor response to Helicobacter eradication therapy.
胃黏膜相关淋巴组织结外边缘区淋巴瘤(胃 MALT 淋巴瘤)来源于边缘区的记忆 B 细胞。正常的记忆 B 细胞不表达生发中心 B 细胞的标志物,如 E2A(免疫球蛋白增强子结合因子 E12/E47)、B 细胞慢性淋巴细胞白血病/淋巴瘤 6(BCL6)或激活诱导胞苷脱氨酶(AID)。E2A 是一种转录因子,它诱导体细胞超突变并阻止浆细胞分化。在 50 例 I 期(E)/II 期(E1)胃 MALT 淋巴瘤中,我们证实所有病例均为 BCL6(-)/AID(-),但有一部分(50%,25/50)为 E2A(+)。由于 E2A(-)和 E2A(+)胃 MALT 淋巴瘤的体细胞超突变数量相似且没有克隆内变异,这表明它们起源于记忆 B 细胞,因此 E2A 的表达最好被视为异常滤泡分化的标志物。尽管 E2A 的表达状态不受体细胞超突变的影响,但 E2A(+)胃 MALT 淋巴瘤的浆细胞样浸润较少,miRNA-223 的表达较高,miRNA-223 与记忆 B 细胞有关。临床上,E2A(+)胃 MALT 淋巴瘤更倾向于向胃周淋巴结扩散,对幽门螺杆菌根除治疗的反应不如 E2A(-)胃 MALT 淋巴瘤。综上所述,异常 E2A 表达是一种胃 MALT 淋巴瘤亚型的诊断特征,其浆细胞样浸润较弱,miRNA-223 表达较强。需要进行前瞻性研究来验证 E2A 表达与对幽门螺杆菌根除治疗反应不佳之间的关联。
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