Department of Histopathology, Armed Forces Institute of Pathology, Rawalpindi, Pakistan.
Department of Forensic Medical Sciences, Molecular Pathology, Armed Forces Institute of Pathology, Rawalpindi, Pakistan.
Asian Pac J Cancer Prev. 2020 Apr 1;21(4):1103-1107. doi: 10.31557/APJCP.2020.21.4.1103.
Diffuse large B-cell lymphomas (DLBCL) are fast-growing non-Hodgkin lymphomas that affect B-lymphocytes. Double expressor DLBCL is the concomitant expression of Myc and Bcl-2 proteins during lymphomas which results in poor prognosis of patients. This study aimed to determine the frequency of double expresser in high grade diffuse large B-cell lymphomas.
The study was conducted on 74 cases (54 males (68.4%) and 20 females (25.3%)) of DLBCL between August 2018 to January 2019. The mean age of the 74 patients was 51.7 years + 18.5. Expression of proteins c-Myc, Bcl-2 and Bcl-6 were evaluated by immunohistochemistry. The involvement of primary lymph node was reported in 38 cases (51.3%) whereas, extra nodal site was observed in 22 cases (29.7%). Among the primary sites, the cervical lymph node enlargement was the most frequent site of presentation.
The rearrangement pattern was studied among 74 patients, 35 (47%) were found to have either one of the rearrangements i.e. Myc, Bcl-2, or Bcl-6. On the other hand, 14 (18.9%) had shown double rearrangements i.e. Bcl-2 and c-Myc (11 cases) and Bcl-6 and c-Myc (3 cases). The Bcl-2 and Bcl-6 rearrangements were demonstrated by 12 cases whereas 2 cases (2.7%) indicated all three types of rearrangements i.e. c-Myc, Bcl-2, and Bcl-6. In 11 cases the Bcl-2 and c-Myc rearrangements were found to be Bcl-2 > 50% and c-Myc > 40% and demonstrating the overall frequency of double expressers as 14.8%. The prognosis of the mentioned cases was extremely poor, median survival of 10 months.
The concurrent expression of Bcl-2 and c-Myc was found to be 14% (level of expression for Bcl-2 > 50% and c-Myc > 40%) which is potentially a significant health burden and an emerging threat.
弥漫性大 B 细胞淋巴瘤（DLBCL）是一种快速生长的非霍奇金淋巴瘤，影响 B 淋巴细胞。双表达者 DLBCL 是指在淋巴瘤期间同时表达 Myc 和 Bcl-2 蛋白，这导致患者预后不良。本研究旨在确定高级别弥漫性大 B 细胞淋巴瘤中双表达者的频率。
本研究于 2018 年 8 月至 2019 年 1 月期间对 74 例 DLBCL 患者（54 名男性（68.4%）和 20 名女性（25.3%））进行了研究。74 例患者的平均年龄为 51.7 岁+18.5 岁。通过免疫组织化学评估蛋白质 c-Myc、Bcl-2 和 Bcl-6 的表达。报告了 38 例（51.3%）原发性淋巴结受累，而观察到 22 例（29.7%）结外部位受累。在原发性部位中，颈淋巴结肿大是最常见的表现部位。
在 74 例患者中研究了重排模式，发现 35 例（47%）存在一种重排，即 Myc、Bcl-2 或 Bcl-6。另一方面，14 例（18.9%）显示出双重重排，即 Bcl-2 和 c-Myc（11 例）和 Bcl-6 和 c-Myc（3 例）。Bcl-2 和 Bcl-6 重排在 12 例中得到证实，而 2 例（2.7%）表明存在三种类型的重排，即 c-Myc、Bcl-2 和 Bcl-6。在 11 例中，发现 Bcl-2 和 c-Myc 重排为 Bcl-2 > 50%和 c-Myc > 40%，表明双表达者的总体频率为 14.8%。这些病例的预后极差，中位生存期为 10 个月。
发现 Bcl-2 和 c-Myc 的同时表达为 14%（Bcl-2 的表达水平> 50%和 c-Myc > 40%），这可能是一个重大的健康负担和新出现的威胁。
