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GATA3免疫组织化学染色在经典型霍奇金淋巴瘤中的应用及其在鉴别诊断中的诊断价值

GATA3 Immunohistochemical Staining in Classical Hodgkin Lymphoma and Its Diagnostic Utility in Differential Diagnosis.

作者信息

Altay Ali Yılmaz, Yeni Erdem Begüm, Yegen Gülçin

机构信息

İstanbul University, İstanbul Faculty of Medicine, Department of Pathology, İstanbul, Türkiye

University of Health Sciences Türkiye, Kartal Dr. Lütfi Kırdar City Hospital, Clinic of Pathology, İstanbul, Türkiye

出版信息

Turk J Haematol. 2025 Feb 28;42(1):9-14. doi: 10.4274/tjh.galenos.2024.2024.0237. Epub 2024 Oct 31.

Abstract

OBJECTIVE

Classical Hodgkin lymphoma (CHL) is a common lymphoid neoplasm with a wide range of differential diagnoses. Although it has a specific immunophenotype, aberrant expression of antigens can cause problems at its diagnosis. In this study we evaluated the usefulness of GATA3 in the differential diagnosis of CHL.

MATERIALS AND METHODS

One hundred cases of CHL and a control group of 106 lymphoma cases, which included anaplastic large-cell lymphoma both positive and negative for anaplastic lymphoma kinase (ALK), Epstein-Barr virus (EBV)-positive large B-cell lymphoma, T-cell/histiocyte-rich B-cell lymphoma, primary mediastinal large B-cell lymphoma, nodular lymphocyte-predominant Hodgkin lymphoma, and mediastinal gray-zone lymphoma, were included in the study. GATA3 immunohistochemistry was applied to all cases and nuclear expression was accepted as positive. Expression status of GATA3 was compared between the CHL group and the control group, as well as among each lymphoma subtype. In addition, whether the biopsy type affected diagnostic performance was assessed. For CHL, the relationship with EBV status and GATA3 expression was evaluated.

RESULTS

GATA3 expression was significantly higher in CHL cases compared to the control group (p<0.001). When compared among individual subgroups, GATA3 was found to be useful in the differential diagnosis of all except for ALK-negative anaplastic large-cell lymphoma (p=0.678) and mediastinal gray-zone lymphoma (p=0.327). GATA3 expression was significantly higher in EBV-negative CHL (p=0.02). In core-needle biopsies, the diagnostic performance was limited (p=0.178).

CONCLUSION

GATA3 is a useful marker for differentiating CHL from B-cell non-Hodgkin lymphomas but its efficiency is limited in ALK-negative anaplastic large-cell lymphoma and mediastinal gray-zone lymphoma. Due to heterogeneous reactions, its diagnostic value is limited in core-needle biopsies.

摘要

目的

经典型霍奇金淋巴瘤(CHL)是一种常见的淋巴样肿瘤,鉴别诊断范围广泛。尽管它具有特定的免疫表型,但抗原的异常表达可能会在诊断时引发问题。在本研究中,我们评估了GATA3在CHL鉴别诊断中的作用。

材料与方法

本研究纳入了100例CHL病例以及一个包含106例淋巴瘤病例的对照组,其中包括间变性淋巴瘤激酶(ALK)阳性和阴性的间变性大细胞淋巴瘤、爱泼斯坦-巴尔病毒(EBV)阳性的大B细胞淋巴瘤、富于T细胞/组织细胞的B细胞淋巴瘤、原发性纵隔大B细胞淋巴瘤、结节性淋巴细胞为主型霍奇金淋巴瘤以及纵隔灰色地带淋巴瘤。对所有病例进行GATA3免疫组织化学检测,细胞核表达被视为阳性。比较CHL组与对照组之间以及各淋巴瘤亚型之间GATA3的表达状态。此外,评估活检类型是否影响诊断性能。对于CHL,评估其与EBV状态和GATA3表达的关系。

结果

与对照组相比,CHL病例中GATA3表达显著更高(p<0.001)。在各个亚组之间进行比较时,发现GATA3除了在ALK阴性的间变性大细胞淋巴瘤(p=0.678)和纵隔灰色地带淋巴瘤(p=0.327)的鉴别诊断中作用不大外,在其他疾病的鉴别诊断中均有用。EBV阴性的CHL中GATA3表达显著更高(p=0.02)。在粗针穿刺活检中,诊断性能有限(p=0.178)。

结论

GATA3是将CHL与B细胞非霍奇金淋巴瘤区分开来的有用标志物,但其在ALK阴性的间变性大细胞淋巴瘤和纵隔灰色地带淋巴瘤中的效率有限。由于反应的异质性,其在粗针穿刺活检中的诊断价值有限。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cd4b/11869154/a1c5d3e22254/TurkJHematol-42-1-9-figure-1.jpg

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