Ismail Sawsan, Elshimali Yahya, Daoud Ali, Alshehabi Zuheir
Department of Pathology, Faculty of Medicine, Tishreen University, Lattakia, Syria.
Cancer Research Center, Tishreen University, Lattakia, Syria.
Ann Med Surg (Lond). 2022 May 14;78:103786. doi: 10.1016/j.amsu.2022.103786. eCollection 2022 Jun.
Non-Hodgkin lymphoma represents a heterogeneous group of tumors that constitute the seventh most common malignancy. Immunohistochemistry plays a major role in the detection of specific cell receptors. Transcription factors are a heterogeneous group of genes that play a critical role in the commitment, differentiation, and proliferation of specific cell types.
Paraffin-embedded tissue sections of non-Hodgkin lymphoma cases were selected, classified, and evaluated before staining with immunohistochemical markers (PAX5, OCT2, BCL6, and P53). Expression of the aforementioned markers was compared with histological subtypes and grades of lymphoma cases. Means of expression were also compared among histological subtypes.
A total of 55 cases of NHL including 26 cases of low-grade lymphomas and 29 cases of high-grade lymphomas were included in the study. DLBCL and FL were the most common subtypes of high-grade and low-grade lymphomas respectively. Both PAX5 and OCT2 were positive in 44 cases of NHL (80%) including all cases of B-cell lymphomas. BCL6 and P53 demonstrated positive expression in 29.1% and 67.3% respectively. Interestingly, we found a significant association between the histological subtypes and the aforementioned markers (P-value<0.05).
Expression of PAX5, OCT2, BCL, and P53 played a major role in the diagnosis and grading of non-Hodgkin lymphomas in our study. Both PAX5 and OCT2 provided more accuracy and specificity in the diagnosis of B-cell neoplasms compared to the classical B-cell markers. BCL6 expression reflected its role in germinal center formation in normal and malignant lymphoid tissues, and expression of P53 mirrored the accumulation of gene mutations in more aggressive lymphoma subtypes.
In this manuscript, we aimed to present a unique study that highlights the immunohistochemical expression of all the aforementioned factors among various histological subtypes of non-Hodgkin lymphomas with disparities in histological aggressiveness, highlighting a promising diagnostic and prognostic panel for non-Hodgkin lymphomas.
非霍奇金淋巴瘤是一组异质性肿瘤，是第七大常见恶性肿瘤。免疫组织化学在特定细胞受体的检测中起主要作用。转录因子是一组异质性基因，在特定细胞类型的定向分化、增殖中起关键作用。
选取非霍奇金淋巴瘤病例的石蜡包埋组织切片，在使用免疫组化标记物（PAX5、OCT2、BCL6和P53）染色前进行分类和评估。将上述标记物的表达与淋巴瘤病例的组织学亚型和分级进行比较。还比较了组织学亚型之间的表达均值。
本研究共纳入55例非霍奇金淋巴瘤病例，其中26例为低级别淋巴瘤，29例为高级别淋巴瘤。弥漫大B细胞淋巴瘤（DLBCL）和滤泡性淋巴瘤（FL）分别是高级别和低级别淋巴瘤最常见的亚型。PAX5和OCT2在44例非霍奇金淋巴瘤（80%）中呈阳性，包括所有B细胞淋巴瘤病例。BCL6和P53的阳性表达率分别为29.1%和67.3%。有趣的是，我们发现组织学亚型与上述标记物之间存在显著关联（P值<0.05）。
在我们的研究中，PAX5、OCT2、BCL和P53的表达在非霍奇金淋巴瘤的诊断和分级中起主要作用。与经典的B细胞标记物相比，PAX5和OCT2在B细胞肿瘤的诊断中提供了更高的准确性和特异性。BCL6的表达反映了其在正常和恶性淋巴组织生发中心形成中的作用，而P53的表达反映了更具侵袭性的淋巴瘤亚型中基因突变的积累。
在本论文中，我们旨在呈现一项独特的研究，突出上述所有因素在组织学侵袭性不同的非霍奇金淋巴瘤各种组织学亚型中的免疫组化表达，为非霍奇金淋巴瘤提供了一个有前景的诊断和预后指标。
