Division of Hematology-Oncology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea.
Clin Lymphoma Myeloma Leuk. 2011 Oct;11(5):403-8. doi: 10.1016/j.clml.2011.05.037. Epub 2011 Jun 22.
Diffuse large B cell lymphoma (DLBCL) of primary nodal (PN) or primary extranodal (PEN) origin may differ immunophenotypically, in that PEN lymphoma cells may originate from activated rather than germinal center B (GCB) cells. We evaluated the relationship between DLBCL clinicopathological features, including expression of B-cell differentiation markers, and primary tumor site.
Expression of CD10, Bcl-6, Bcl-2, and MUM1 was determined in paraffin-embedded tissues from 123 patients with DLBCL.
Of the 123 patients with DLBCL, 40 (32.5%) had the GCB and 83 (67.5%) had the non-GCB phenotype. Fifty-one patients (42%) showed disease involvement at PEN sites, including 29 with disease in the gastrointestinal (GI) tract (14 in the stomach, 15 in the intestine). Of these 51 patients, 16 (31.4%) were classified with the GCB and 35 (68.5%) with the non-GCB subtype. There were no differences in the frequencies of GCB and non-GCB subtypes among primary sites. Of the 72 patients with PN DLBCL, 22 (31%) had the GCB and 50 (69%) had the non-GCB subtype. There were no differences in the frequencies of GCB and non-GCB subtypes between patients with PN and PEN DLBCL. Although lactate dehydrogenase (LDH) concentration > normal, stage >II, and rituximab-cyclophosphamide, doxorubicin, vincristine, and prednisone (RCHOP) treatment were independent predictors of overall survival (OS), GCB subtype, and presence of PEN disease failed to predict survival upon multivariate analysis.
There was no difference in GCB and non-GCB phenotypes between patients with PN and PEN DLBCLs. Additional studies are needed to further assess molecular differences between the two groups.
原发于结内（PN）或结外（PEN）的弥漫性大 B 细胞淋巴瘤（DLBCL）在免疫表型上可能存在差异，PEN 淋巴瘤细胞可能来源于活化而非生发中心 B（GCB）细胞。我们评估了 DLBCL 临床病理特征（包括 B 细胞分化标志物的表达）与原发肿瘤部位之间的关系。
对 123 例 DLBCL 患者的石蜡包埋组织进行 CD10、Bcl-6、Bcl-2 和 MUM1 的表达检测。
在 123 例 DLBCL 患者中，40 例（32.5%）为 GCB 型，83 例（67.5%）为非 GCB 型。51 例（42%）患者存在 PEN 部位疾病累及，包括 29 例胃肠道（GI）疾病（胃 14 例，肠 15 例）。这 51 例患者中，16 例（31.4%）为 GCB 型，35 例（68.5%）为非 GCB 型。原发部位的 GCB 和非 GCB 亚型频率无差异。在 72 例 PN DLBCL 患者中，22 例（31%）为 GCB 型，50 例（69%）为非 GCB 型。PN 和 PEN DLBCL 患者的 GCB 和非 GCB 亚型频率无差异。尽管乳酸脱氢酶（LDH）浓度>正常值、分期>II 期和利妥昔单抗-环磷酰胺、多柔比星、长春新碱和泼尼松（RCHOP）治疗是总生存（OS）的独立预测因素，但多变量分析时 GCB 亚型和 PEN 疾病的存在并不能预测生存。
PN 和 PEN DLBCL 患者的 GCB 和非 GCB 表型无差异。需要进一步研究来评估这两组之间的分子差异。
