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[儿童散发性伯基特淋巴瘤的分子遗传学特征]

[Molecular genetic features of sporadic Burkitt's lymphoma in children].

作者信息

Yang Wen-Ping, Huang Hui, Gong Li-Ping, Wu Yan, Xu Hong-Yan, Zou Yin, Lü Bei-Bei, Zhong Hua-Sheng, Deng Qing-Qiang, Xiao Qiang, Zeng Song-Tao, Zhu Cai-di

机构信息

Department of Pathology, Jiangxi Children's Hospital, Nanchang 330006, China.

出版信息

Zhonghua Bing Li Xue Za Zhi. 2010 Dec;39(12):819-24.

Abstract

OBJECTIVE

To investigate the molecular genetic features and diagnostic aspects of sporadic Burkitt's lymphoma (BL) in children.

METHODS

Tissue microarray was constructed to include 64 cases of pediatric BL and 6 cases of pediatric diffuse large B-cell lymphoma (DLBCL). Immunohistochemistry and fluorescence in-situ hybridization for c-myc, bcl-2, bcl-6, IgH, myc/IgH and bcl-2/IgH gene were performed. Cases of pediatric Burkitt's lymphomas were subclassified into three groups based on their cellular orgins: the germinal center (GC) group, the late-germinal center (late-GC) group and the post-germinal center (post-GC) group.

RESULTS

Among 64 Burkitt's lymphomas studied, expression of CD20, CD10, bcl-6, bcl-2 and MUM1 by immunohistochemistry were 100% (64 cases), 98.4% (63 cases), 96.9% (62 cases), 0 (0 cases) and 23.4% (15 cases), respectively. Various gene rearrangements were found involving the c-myc 93.1% (54/58 cases) and IgH 82.8% (48/58 cases). Detailed rearrangements are as follows: 46 cases (85.2%) myc/IgH gene translocation along with c-myc and IgH gene rearrangement; 4 cases (7.4%) c-myc gene rearrangement without IgH and myc/IgH abnormality; 4 cases (7.4%) without c-myc, IgH or myc/IgH gene rearrangement. No case showed bcl-2 gene abnormality (100%). Fifty nine cases showed normal bcl-6 gene status. One case had bcl-6 gene rearrangement and amplification with the pathologic and immunophenotypic characteristics of BL, leading to a revised pathological diagnosis of B-cell lymphoma, unclassifiable with features intermediate between diffuse large B-cell lymphoma and Burkitt's lymphoma (DLBCL/BL). Two cases showed c-myc gene rearrangement. Two cases showed bcl-6 gene amplification and 6 DLBCL cases had a normal status of bcl-2/IgH.

CONCLUSIONS

A majority of pediatric sporadic BL arise from the germinal center B cells, most of which have c-myc gene rearrangement. It is useful to distinguish BL and DLBCL by multiple genes detection.

摘要

目的

探讨儿童散发性伯基特淋巴瘤(BL)的分子遗传学特征及诊断要点。

方法

构建组织芯片,纳入64例儿童BL和6例儿童弥漫性大B细胞淋巴瘤(DLBCL)。对c-myc、bcl-2、bcl-6、IgH、myc/IgH和bcl-2/IgH基因进行免疫组织化学和荧光原位杂交检测。根据细胞起源将儿童伯基特淋巴瘤病例分为三组:生发中心(GC)组、晚期生发中心(late-GC)组和生发中心后(post-GC)组。

结果

在研究的64例伯基特淋巴瘤中,免疫组织化学检测CD20、CD10、bcl-6、bcl-2和MUM1的表达分别为100%(64例)、98.4%(63例)、96.9%(62例)、0(0例)和23.4%(15例)。发现多种基因重排,涉及c-myc的占93.1%(54/58例),IgH的占82.8%(48/58例)。具体重排情况如下:46例(85.2%)myc/IgH基因易位伴c-myc和IgH基因重排;4例(7.4%)c-myc基因重排但无IgH和myc/IgH异常;4例(7.4%)无c-myc、IgH或myc/IgH基因重排。无病例显示bcl-2基因异常(100%)。59例bcl-6基因状态正常。1例bcl-6基因重排并扩增,具有BL的病理和免疫表型特征,导致病理诊断修订为B细胞淋巴瘤,无法分类,具有弥漫性大B细胞淋巴瘤和伯基特淋巴瘤之间的中间特征(DLBCL/BL)。2例显示c-myc基因重排。2例显示bcl-6基因扩增,6例DLBCL病例bcl-2/IgH状态正常。

结论

大多数儿童散发性BL起源于生发中心B细胞,其中大多数有c-myc基因重排。通过多基因检测区分BL和DLBCL很有用。

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