Che Yi-Qun, Liu Peng, Luo Yang, Shen Di, Hao Jia-Jie, Yang Lin, Zhang Chang-Gong, Qi Jun, Wang Ming-Rong
Clin Lab. 2014;60(6):989-98. doi: 10.7754/clin.lab.2013.130517.
We sought to investigate the role of the Bcl-2 translocation at the chromosomal and protein levels in minimal bone marrow (BM) infiltration by diffuse large B-cell lymphomas (DLBCL).
The presence of the Bcl-2/IgH fusion gene was detected in BM samples and paraffin-embedded lymph node (LN) samples from 103 patients with DLBCLs using FISH. Bcl-2 protein levels in BM and paraffin-embedded tissues were quantified using immunocytochemistry (ICC) and immunohistochemistry (IHC), respectively.
Bcl-2/IgH translocation in paraffin-embedded LN tissue sections was observed in 43 (41.7%) patients by FISH. Of the 43 patients, the Bcl-2/IgH rearrangement in the bone marrow specimens occurred in 34 patients. The Bcl-2/IgH recombination rate in stage III cancers was not significantly different compared to the rate observed in stage I/II cancers (p = 0.101), respectively showing no statistical differences between stage IV and I/II (p = 0.179). In 64.7% (22/34) of the cases with t(14;18), Bcl-2 was detected based on ICC analysis. Positive Bcl-2 ICC staining and the t(14;18) translocation were positively correlated (p < 0.001). We then applied our FISH method to slides with at least one abnormal cell and were subjected to FISH analysis after staining. During the follow-up, no infiltration by cytomorphology for 16 DLBCL patients whose bone marrow presented Bcl-2/IgH gene rearrangement at diagnosis, and two cases were positive by morphology compared to FISH-positive results 6 months later; 9 out of 16 patients (56.3%) presented with positive Bcl-2/IgH results earlier than the morphology evaluation after 12 months.
Utilizing both FISH and cytologic morphology, the assessment of Bcl-2/IgH translocation status could contribute to the better detection of minimal bone marrow infiltration and relapse receiving treatment by DLBCL cells.
我们试图在染色体和蛋白质水平上研究Bcl-2易位在弥漫性大B细胞淋巴瘤（DLBCL）微小骨髓浸润中的作用。
使用荧光原位杂交（FISH）检测103例DLBCL患者骨髓样本和石蜡包埋淋巴结（LN）样本中Bcl-2/IgH融合基因的存在情况。分别使用免疫细胞化学（ICC）和免疫组织化学（IHC）对骨髓和石蜡包埋组织中的Bcl-2蛋白水平进行定量分析。
通过FISH在43例（41.7%）患者的石蜡包埋LN组织切片中观察到Bcl-2/IgH易位。在这43例患者中，34例患者的骨髓标本中出现Bcl-2/IgH重排。III期癌症的Bcl-2/IgH重组率与I/II期癌症观察到的率相比无显著差异（p = 0.101），IV期与I/II期之间也无统计学差异（p = 0.179）。在64.7%（22/34）的t(14;18)病例中，基于ICC分析检测到Bcl-2。Bcl-2 ICC染色阳性与t(14;18)易位呈正相关（p < 0.001）。然后我们将FISH方法应用于至少有一个异常细胞的玻片，并在染色后进行FISH分析。在随访期间，16例诊断时骨髓呈现Bcl-2/IgH基因重排的DLBCL患者，通过细胞形态学未发现浸润，6个月后2例形态学阳性与FISH阳性结果一致；16例患者中有9例（56.3%）在12个月后Bcl-2/IgH结果阳性早于形态学评估。
同时利用FISH和细胞学形态，评估Bcl-2/IgH易位状态有助于更好地检测DLBCL细胞对微小骨髓浸润和复发的治疗情况。
