北美人群中的胃肠道淋巴瘤：来自美国中西部一主要三级医疗中心的临床病理特征。
Gastrointestinal lymphomas in a North American population: clinicopathologic features from one major Central-Midwestern United States tertiary care medical center.
机构信息
Department of Pathology & Immunology, Washington University Medical School, 660 S, Euclid Ave, Campus Box 8118, St Louis, MO 63110, USA.
出版信息
Diagn Pathol. 2012 Jun 28;7:76. doi: 10.1186/1746-1596-7-76.
BACKGROUND
Gastrointestinal (GI) lymphomas are very common types of extranodal lymphomas, and we hypothesize there are regional differences in subtype, distribution in the GI tract, and epidemiological features among the different populations.
METHODS
We retrospectively evaluated the clinical, molecular and histologic features of North American primary and secondary GI lymphomas diagnosed from 2000-2009 seen at our institution. We utilized immunohistochemistry and fluorescence in situ hybridization to further evaluate a subset of the gastric lymphomas.
RESULTS
Extranodal marginal zone lymphomas of mucosal associated lymphoid tissue (MALTs) and diffuse large B cell lymphomas (DLBCLs) were the most common subtypes of GI lymphomas. Select gastric DLBCLs (N = 6) and MALTs (N = 13) were further examined for API2-MALT1 and IGH translocations, and P16 and P53 protein expression. Gastric MALTs showed frequent API2-MALT1 (38%) but not IGH translocations (0%), and the DLBCLs showed neither translocation. Expression of P16 and P53 proteins and the proliferative index were compared between high grade gastric lymphomas (gastric DLBCLs) and low grade gastric lymphomas (gastric MALTs). P53 overexpression (P = 0.008) and a high proliferation index [Ki-67] (P = 0.00042) were significantly associated with gastric DLBCL, but no statistically significant difference was observed in P16 expression (p = 0.108) between gastric DLBCL and gastric MALT.
CONCLUSION
Our study revealed that GI lymphomas from a Central-Midwestern North American population showed differences and similarities to non-North American cohorts. In addition, API2-MALT1, P16 and P53 abnormalities occurred frequently in gastric lymphomas from this North American population.
VIRTUAL SLIDES
The virtual slides for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1415505838687793.
背景
胃肠道（GI）淋巴瘤是非常常见的结外淋巴瘤类型，我们假设在不同人群中，亚型、在胃肠道中的分布以及流行病学特征存在区域性差异。
方法
我们回顾性评估了 2000-2009 年在我们机构诊断的北美原发性和继发性胃肠道淋巴瘤的临床、分子和组织学特征。我们利用免疫组织化学和荧光原位杂交进一步评估了一部分胃淋巴瘤。
结果
黏膜相关淋巴组织（MALT）的结外边缘区淋巴瘤和弥漫性大 B 细胞淋巴瘤（DLBCL）是胃肠道淋巴瘤最常见的亚型。选择了 6 例胃 DLBCL 和 13 例 MALT 进一步检查 API2-MALT1 和 IGH 易位以及 P16 和 P53 蛋白表达。胃 MALT 显示频繁的 API2-MALT1（38%）但没有 IGH 易位（0%），而 DLBCL 则没有易位。比较了高等级胃淋巴瘤（胃 DLBCL）和低等级胃淋巴瘤（胃 MALT）之间的 P16 和 P53 蛋白表达和增殖指数。P53 过表达（P=0.008）和高增殖指数[Ki-67]（P=0.00042）与胃 DLBCL 显著相关，但胃 DLBCL 和胃 MALT 之间 P16 表达无统计学差异（p=0.108）。
结论
我们的研究表明，来自中中西部北美人群的胃肠道淋巴瘤与非北美队列存在差异和相似之处。此外，API2-MALT1、P16 和 P53 异常在该北美人群的胃淋巴瘤中经常发生。
幻灯片
本文的虚拟幻灯片可在此处找到：http://www.diagnosticpathology.diagnomx.eu/vs/1415505838687793.
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