Chang Sheng-Tsung, Chen Shang-Wen, Ho Chung-Han, Kuo Chun-Chi, Sakata Seiji, Takeuchi Kengo, Chuang Shih-Sung
Department of Pathology, Chi-Mei Medical Center, Tainan, Taiwan; Department of Nursing, National Tainan Institute of Nursing, Tainan, Taiwan.
Division of Hemato-Oncology, Department of Internal Medicine, Chi-Mei Medical Center, Liouying, Taiwan.
J Formos Med Assoc. 2016 Nov;115(11):961-967. doi: 10.1016/j.jfma.2016.09.006. Epub 2016 Oct 20.
BACKGROUND/PURPOSE: Diffuse large B-cell lymphoma (DLBCL) is the most common lymphoma type. The immunophenotypic and genetic features of DLBCL in Taiwan have not been characterized.
In this study, we performed immunohistochemical analysis and interphase fluorescence in situ hybridization (FISH) using tissue microarray sections to investigate a cohort of unselected DLBCL cases in a single institution in Taiwan from 1990 to 2010.
Of the 153 cases investigated, CD10, bcl-6, and MUM1 were expressed in 16.3%, 71.2%, and 71.9% cases, respectively, with 27.5% (n = 42) of cases being classified as having a germinal center B-cell (GCB) origin by the Hans algorithm. By FISH analysis, 19.6%, 4.6%, 26.1%, and 3.9% cases showed rearrangement at IGH, BCL2, BCL6, and MYC loci, respectively, including three (2.0%) cases of double-hit lymphoma. As compared with the non-GCB tumors, GCB tumors more frequently expressed CD10 (p < 0.001) and bcl-6 (p = 0.001) with less frequent expression of MUM1 (p = 0.007). Moreover, GCB tumors more frequently exhibited rearrangement at the BCL2 (p = 0.024) and MYC (p = 0.038) loci than non-GCB tumors. However, there was no survival difference between these two groups.
In this first series of DLBCL evaluation from Taiwan, we found that the relative frequency of GCB tumors among DLBCL was low in most East Asian countries. There is a wide range of BCL2 rearrangement rates, higher in the West and lower in East Asia. A larger and/or national study is warranted to better understand the immunophenotypic and molecular features of DLBCL in Taiwan and their respective impact on patient survival.
背景/目的:弥漫性大B细胞淋巴瘤(DLBCL)是最常见的淋巴瘤类型。台湾地区DLBCL的免疫表型和基因特征尚未明确。
在本研究中,我们使用组织微阵列切片进行免疫组织化学分析和间期荧光原位杂交(FISH),以调查1990年至2010年台湾某单一机构中一组未经选择的DLBCL病例。
在153例研究病例中,CD10、bcl-6和MUM1的表达率分别为16.3%、71.2%和71.9%,根据Hans算法,27.5%(n = 42)的病例被归类为生发中心B细胞(GCB)起源。通过FISH分析,分别有19.6%、4.6%、26.1%和3.9%的病例在IGH、BCL2、BCL6和MYC基因座发生重排,包括3例(2.0%)双打击淋巴瘤。与非GCB肿瘤相比,GCB肿瘤更频繁地表达CD10(p < 0.001)和bcl-6(p = 0.001),而MUM1表达较少(p = 0.007)。此外,GCB肿瘤比非GCB肿瘤更频繁地在BCL2(p = 0.024)和MYC(p = 0.038)基因座发生重排。然而,这两组之间的生存率没有差异。
在台湾地区首次进行的这一系列DLBCL评估中,我们发现DLBCL中GCB肿瘤的相对频率在大多数东亚国家较低。BCL2重排率范围广泛,在西方较高,在东亚较低。有必要进行更大规模的和/或全国性的研究,以更好地了解台湾地区DLBCL的免疫表型和分子特征及其对患者生存的各自影响。