免疫表型对 Burkitt 淋巴瘤、双打击高级别 B 细胞淋巴瘤和单打击 MYC 重排弥漫性大 B 细胞淋巴瘤的研究和鉴别诊断的贡献。

Contribution of immunophenotype to the investigation and differential diagnosis of Burkitt lymphoma, double-hit high-grade B-cell lymphoma, and single-hit MYC-rearranged diffuse large B-cell lymphoma.

机构信息

Department of Laboratory Hematology, Athens Regional General Hospital Georgios Gennimatas, Athens, Greece.

Department of Clinical Hematology, Athens Regional General Hospital Georgios Gennimatas, Athens, Greece.

出版信息

Cytometry B Clin Cytom. 2020 Sep;98(5):412-420. doi: 10.1002/cyto.b.21887. Epub 2020 Jun 4.

DOI:10.1002/cyto.b.21887

PMID:32497402

Abstract

BACKGROUND

There are no immunophenotypic guidelines for the investigation of MYC-rearranged lymphomas. We aimed to identify simple immunophenotypic features that would help to differentiate between MYC-rearranged lymphomas and guide cytogenetic analysis.

METHODS

We reviewed diagnostic samples from patients diagnosed with Burkitt lymphoma (BL), double-hit lymphoma (DHL), MYC-rearranged diffuse large B-cell lymphoma (MYC-DLBCL), and standard (non-MYC-rearranged) DLBCL over the last decade in our Institution. Using flow cytometry (with antibodies CD20, CD10, CD38, bcl-2, Ki-67, FMC-7, CD43, CD27, CD79b, CD23, and CD22) we determined antigen% expression and median-fluorescence intensity ratios (MFIR). The forward scatter (FS) and side scatter (SS) characteristics of tumor B-cells were compared with normal T-cells (B/T ratios) for patients with MYC-rearranged lymphomas.

RESULTS

We identified 51 patients of whom 14 had BL, 10 had DHL (6 MYC+/BCL2+; 4 MYC+/BCL6+), 8 MYC-DLBCL, and 19 standard DLBCL. The significant differences (p <.05) were: higher CD38% in BL than standard DLBCL; higher CD10% in BL and DHL versus MYC-DLBCL and standard DLBCL; higher CD10MFIR in BL than MYC-DLBCL and standard DLBCL; higher Ki-67% in BL than DHL and MYC-DLBCL; higher bcl-2% in DHL than BL; higher FMC-7% in BL than MYC-DLBCL and standard DLBCL; and lower SS (B/T) ratio in DHL than MYC-DLBCL.

CONCLUSIONS

The combination of CD38% > 90, CD10% > 80, CD10MFIR > 10, bcl-2% < 30, and Ki-67% > 70 was characteristic of BL. "Deviation" from these cut-offs should raise suspicion for DHL and, therefore, BCL2 and/or BCL6 FISH is required. We also found that a diagnosis of DHL rather than of MYC-DLBCL was significantly associated with CD10% > 60, Ki-67% > 50, and SS (B/T) <1.5.

摘要

背景

目前尚无用于研究 MYC 重排淋巴瘤的免疫表型指南。本研究旨在确定简单的免疫表型特征，以帮助区分 MYC 重排淋巴瘤并指导细胞遗传学分析。

方法

我们回顾了过去十年间在本机构诊断为伯基特淋巴瘤（BL）、双打击淋巴瘤（DHL）、MYC 重排弥漫性大 B 细胞淋巴瘤（MYC-DLBCL）和标准（非 MYC 重排）DLBCL 的患者的诊断样本。使用流式细胞术（抗体包括 CD20、CD10、CD38、bcl-2、Ki-67、FMC-7、CD43、CD27、CD79b、CD23 和 CD22），我们确定了抗原%表达和中荧光强度比（MFIR）。对于 MYC 重排淋巴瘤患者，比较肿瘤 B 细胞的前向散射（FS）和侧向散射（SS）特征与正常 T 细胞（B/T 比值）。

结果

我们共纳入了 51 例患者，其中 14 例为 BL，10 例为 DHL（6 例为 MYC+/BCL2+；4 例为 MYC+/BCL6+），8 例为 MYC-DLBCL，19 例为标准 DLBCL。BL 患者的 CD38%显著高于标准 DLBCL（p<.05），BL 和 DHL 的 CD10%显著高于 MYC-DLBCL 和标准 DLBCL（p<.05），BL 的 CD10MFIR 显著高于 MYC-DLBCL 和标准 DLBCL（p<.05），BL 的 Ki-67%显著高于 DHL 和 MYC-DLBCL（p<.05），DHL 的 bcl-2%显著高于 BL（p<.05），BL 的 FMC-7%显著高于 MYC-DLBCL 和标准 DLBCL（p<.05），DHL 的 SS（B/T）比值显著低于 MYC-DLBCL（p<.05）。

结论

CD38%>90、CD10%>80、CD10MFIR>10、bcl-2%<30 和 Ki-67%>70 的组合特征符合 BL。这些截点的“偏差”应提示存在 DHL，因此需要进行 BCL2 和/或 BCL6 FISH。我们还发现，与 MYC-DLBCL 相比，DHL 的诊断与 CD10%>60、Ki-67%>50 和 SS（B/T）<1.5 显著相关。